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目的:研究进展期胃癌患者全胃切除D_2淋巴结清扫微创手术效果。方法:选择2012年3月—2014年3月在接受手术治疗的进展期胃癌患者100例,将患者分为观察组和对照组,其中观察组采用全胃切除D_2淋巴结清扫微创手术,即腹腔镜辅助胃癌根治术,共50例,对照组采用开腹手术,共50例。术后对所有患者进行随访,将两组患者术后病理、并发症及生存状况等进行分析对比。结果:观察组手术出血量、首次下床活动时间、肛门排气时间、术后住院时间均优于对照组,差异有统计学意义(P<0.05);两组患者术后并发症情况比较,观察组并发症发生率明显低于对照组(P<0.05);两组患者手术病理结果比较,淋巴结清扫数目和近切缘、远切缘距肿瘤的距离均差异无统计学意义(P>0.05);两组患者的术后生存情况比较,观察组生存率略高于对照组,无瘤生存率也略高于对照组,差异不具有统计学意义(P>0.05)。结论:全胃切除D_2淋巴结清扫微创手术,并发症发生率低、术后生存状况良好。
Objective: To study the effect of total gastrectomy D_2 lymph node dissection in patients with advanced gastric cancer. Methods: From March 2012 to March 2014, 100 patients with advanced gastric cancer undergoing surgery were selected. The patients were divided into observation group and control group. The observation group was treated by total gastrectomy D_2 lymph node dissection minimally invasive surgery, ie, abdominal cavity Mirror assisted radical gastrectomy, a total of 50 cases, the control group of open surgery, a total of 50 cases. All patients were followed up after surgery, the two groups of patients postoperative pathology, complications and survival conditions were analyzed and compared. Results: The amount of operation bleeding, time to bed activity, anal exhaust time and postoperative hospital stay in the observation group were better than those in the control group (P <0.05). Comparing the postoperative complications, The incidence of complications in the observation group was significantly lower than that in the control group (P <0.05). There was no significant difference between the two groups in the number of pathological findings, the number of lymph node dissection, ). The survival rate of the two groups was slightly higher than that of the control group, and the survival rate of the two groups was also slightly higher than that of the control group. The difference was not statistically significant (P> 0.05). Conclusion: Total gastrectomy D_2 lymph node dissection minimally invasive surgery, the incidence of complications is low, postoperative survival is good.