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目的分析腹腔镜辅助D2根治术治疗远端进展期胃癌患者临床疗效。方法选取行D2根治术的远端进展期胃癌患者71例,随机分为对照组35例和观察组36例,对照组行开腹胃癌D2根治术,观察组行腹腔镜辅助D2根治术,比较两组的手术情况、术后肛门排气时间、并发症及生存质量。结果观察组手术时间〔(217.62±51.52)min〕相对于对照组〔(173.59±43.85)min〕明显要长,观察组术中出血量、肛门排气时间、住院时间均少于对照组(P<0.05);对照组的淋巴结清扫数18.62±5.61,观察组为17.53±4.28,两组比较差异无统计学意义(P>0.05);对照组术后并发症发生率为25.71%,观察组为22.22%,两组比较差异无统计学意义(P>0.05);对照组术后1 w的生活质量评分为73.72±13.28,观察组为81.49±15.51,差异有统计学意义(P<0.05),但术后1个月两组的生活质量评分比较,差异无统计学意义(P>0.05);对照组的肿瘤近端切縁和远端切縁长度分别为(4.54±1.22)cm、(4.31±1.12)cm,观察组分别为(5.36±2.31)cm、(3.83±1.03)cm,差异无统计学意义(P>0.05)。结论腹腔镜辅助D2根治术治疗远端进展期胃癌可达到胃癌D2根治术的目的,安全可靠,且能减少术中出血量,缩短住院时间,临床可予推广应用。
Objective To analyze the clinical effect of laparoscopic-assisted radical D2 surgery in the treatment of patients with advanced gastric cancer. Methods Totally 71 patients with distal advanced gastric cancer who underwent D2 radical mastectomy were randomly divided into control group (n = 35) and observation group (n = 36). The control group received D2 radical gastrectomy for gastric cancer. The observation group received laparoscopic-assisted D2 radical surgery The two groups of surgery, postoperative anal exhaust time, complications and quality of life. Results The operation time of the observation group was (217.62 ± 51.52) min, which was significantly longer than that of the control group (173.59 ± 43.85 min). The intraoperative blood loss, anal exhaust time and hospital stay in the observation group were all less than those in the control group <0.05). The number of lymph node dissection in the control group was 18.62 ± 5.61 and in the observation group was 17.53 ± 4.28, there was no significant difference between the two groups (P> 0.05). The incidence of postoperative complications in the control group was 25.71% 22.22% respectively. There was no significant difference between the two groups (P> 0.05). The quality of life at 1 w after operation in control group was 73.72 ± 13.28 and in observation group was 81.49 ± 15.51, the difference was statistically significant (P <0.05) However, there was no significant difference in quality of life scores between the two groups at 1 month after operation (P> 0.05). The length of the proximal and distal incision in the control group were (4.54 ± 1.22) cm and (4.31 ± 1.12) cm in the observation group and (5.36 ± 2.31) cm and (3.83 ± 1.03) cm in the observation group, respectively, with no significant difference (P> 0.05). Conclusion laparoscopic-assisted radical D2 surgery for advanced gastric cancer can achieve the purpose of D2 radical surgery of gastric cancer, safe and reliable, and can reduce intraoperative bleeding and shorten the length of stay, the clinical application may be extended.