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目的探讨腹腔镜D2根治术治疗进展期胃癌的疗效及并发症。方法选取2014年3月至2016年1月间攸县人民医院收治的64例进展期胃癌患者,采用随机数表法分为观察组与对照组,每组32例。观察组患者采用腹腔镜D2根治术,对照组患者采用传统开腹远端胃切除术。比较两组患者手术相关指标、术后1个月机体功能恢复情况、并发症发生率及1年生存率。结果观察组患者手术切口长度和手术用时少于对照组患者,差异均有统计学意义(均P<0.05)。观察组患者肛门排气时间、下床活动时间、开始进食时间、住院时间及术后胃部出血量均少于对照组患者,差异均有统计学意义(均P<0.05)。观察组患者并发症发生率为12.5%,低于对照组患者的37.5%,差异有统计学意义(P<0.05)。两组患者1年生存率比较,差异无统计学意义(P>0.05)。结论采用腹腔镜D2根治术治疗进展期胃癌患者疗效显著,可减少手术用时和术后胃部出血量,促使患者康复,降低疾病病死率,安全性较高。
Objective To investigate the efficacy and complications of laparoscopic D2 radical mastectomy for advanced gastric cancer. Methods 64 patients with advanced gastric cancer admitted to Youxian People’s Hospital from March 2014 to January 2016 were randomly divided into observation group and control group with 32 cases in each group. The patients in the observation group were treated with laparoscopic radical D2 and the patients in the control group were treated by conventional open gastrectomy. The operation-related indexes of the two groups were compared, the recovery of the function of the body one month after operation, the complication rate and the one-year survival rate were compared. Results The surgical incision length and operative time in the observation group were less than those in the control group, with significant differences (all P <0.05). In the observation group, the anal exhaust time, ambulation time, onset time, hospital stay and postoperative gastric bleeding were less than those in the control group (all P <0.05). The incidence of complication in the observation group was 12.5%, which was lower than that in the control group (37.5%), the difference was statistically significant (P <0.05). There was no significant difference in one-year survival between the two groups (P> 0.05). Conclusion The treatment of advanced gastric cancer with laparoscopic D2 radical surgery has significant curative effect, which can reduce the amount of bleeding during surgery and after operation, promote the rehabilitation of patients, reduce the mortality rate of the disease and have higher safety.