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目的:比较远端胃癌应用腹腔镜辅助技术行D2根治术与传统开腹远端胃癌D2根治术安全性、近期生存差异。方法:回顾性分析2010年1月-2012年12月在我院行远端胃癌根治术的158例患者,其中行腹腔镜辅助远端胃癌根治手术75例(腹腔镜组),与开腹远端胃癌根治手术83例(开腹组)。对比分析腹腔镜组与开腹组病人术中情况和术后并发症及近期生存差异。结果:腹腔镜组与传统开腹组病人一般资料、病理学类型、肿瘤位置、肿瘤浸润深度、转移淋巴结数目、总清扫淋巴结数目、肿瘤TNM分期比较差异无统计学意义(P>0.05),腹腔镜组手术时间较传统开腹组长(P<0.05),切口长度、离床活动时间、排气时间、进流食时间、总住院时间短于开腹组,差异有统计学意义(P<0.05),腹腔镜组与开腹组术中出血量、术后并发症发生率、近期生存率比较差异无统计学意义(P>0.05)。结论:腹腔镜辅助胃癌D2根治性手术安全可行,可达到开腹手术相同的根治效果,但较开腹组具有术中创伤小、术后恢复快优势。
OBJECTIVE: To compare the safety and short-term survival difference between D2 radical mastectomy and traditional open radical D2 gastroscopic radical mastectomy for distal gastric cancer undergoing laparoscopy. Methods: A retrospective analysis of 158 patients with distal radical gastrectomy in our hospital from January 2010 to December 2012 was performed. Among them, laparoscopic assisted radical gastrectomy for distal gastric cancer was performed in 75 patients (laparoscopic group) 83 cases of radical operation of gastric cancer (open group). Comparative analysis of laparoscopic group and open group of patients with intraoperative and postoperative complications and short-term survival differences. Results: There was no significant difference in general information, pathological type, tumor location, depth of tumor invasion, number of metastatic lymph nodes, total lymph node dissection and tumor TNM stage between laparoscopic group and conventional laparotomy group (P> 0.05) The operation time of the mirror group was longer than that of the traditional open group (P <0.05). The length of the incision, the time of leaving the bed, the time of exhausting, the time of feeding into the stream and the total hospital stay were shorter than those of the open group (P <0.05) ), Laparoscopic group and open group intraoperative blood loss, postoperative complication rate, the recent survival rate was no significant difference (P> 0.05). Conclusions: Laparoscopic assisted radical resection of gastric cancer D2 is safe and feasible, which can achieve the same radical effect of laparotomy. Compared with the open group, it has the advantages of less intraoperative trauma and faster recovery after operation.