【摘要】 目的 研究腹腔鏡行進展期胃癌根治術較傳統開腹手術在圍手術期臨床和生化指標的變化，進一步探討其臨床應用的優越性。 方法 采用統一入組標準、同期臨床對比研究方法，對2010年1-12月腹腔鏡手術組和開腹手術組完成的112例進展期胃癌根治術患者在圍手術期臨床指標和生化指標的比較分析，其中腹腔鏡手術組59例，開腹手術組53例。 結果 腹腔鏡組手術切口長度為（5.77±0.74） cm，開腹手術組為（12.05±1.30） cm，組間差異有統計學意義（t=-30.921，P=0.000）；腹腔鏡組術中失血量為（107.20±27.23） mL，開腹手術組為（168.87±96.76） mL，組間差異有統計學意義（t=-4.483，P=0.000）；腹腔鏡組術后住院時間為（7.19±0.97） d，開腹手術組為（8.32±1.16） d，組間差異有統計學意義（t=-5.634，P=0.000）；腹腔鏡組手術時間為（202.12±15.71） min，開腹手術組為（196.32±16.73） min，組間差異無統計學意義（t=1.891，P=0.061）；腹腔鏡組清掃淋巴結枚數（14.15±4.51）枚，開腹手術組（15.25±5.17）枚，組間差異無統計學意義（t=0.736，P=0.471）；腹腔鏡組腸功能恢復時間為（57.88±9.70） h，開腹手術組為（59.16±10.82） h，組間差異無統計學意義（t=-0.655，P=0.514）。兩組前白蛋白和血紅蛋白水平差異無統計學意義（P gt;0.05）。 結論 進展期胃癌行腹腔鏡手術與傳統開腹手術比較，并不加重患者創傷反應，也不增加手術并發癥，具有手術切口小、術中出血少、術后恢復快等優點。
【Abstract】 Objective To evaluate the differences between laparoscopy and open surgery for treating advanced gastric cancer in peri-operative clinical and biochemical indexes, in order to investigate the superiority of laparoscopy in treating the disease. Methods The same including standards and double-blind randomized control study were carried out to compare the peri-operative clinical and biochemical indexes of 112 patients who underwent radical treatment for advanced gastric cancer from January to December 2010. Among them, 59 patients were included in the laparoscopic group, and 53 in the traditional open operation group. Results Compared with the open surgery group, the incision length [(5.77±0.74) cm vs. (12.05±1.30) cm; t=-30.921, P=0.000], intraoperational blood loss [(107.20±27.23) mL vs. (168.87±96.76) mL; t=-4.483, P=0.000] and hospital stay time [(7.19±0.97) days vs. (8.32±1.16) days; t=-5.634, P=0.000] were significantly shorter or lower in the laparoscopic group. However, the operation time [(202.12±15.71) minutes vs. (196.32±16.73) minutes; t=1.891, P=0.061], number of lymph nodes removed (14.15±4.51 vs. 15.25±5.17; t=0.736, P=0.471), and intestinal functioning time [(57.88±9.70) hours vs. (59.16±10.82) hours; t=-0.655, P=0.514] were not significantly different between the two groups. There was no significant difference between the two groups in the level of prealbumin and hemoglobin. Conclusion Compared with the traditional open operation, laparoscopic surgery for gastric cancer has obvious advantages including smaller incision, lower blood loss during the operation, and fast recovery, without aggravating patients′ traumatic response or increasing the incidence of operational complications.
Citation： LUO Guode,CAO Yongkuan,ZHANG Lin,ZHANG Guohu,WANG Peihong,GONG Jiaqing,WANG Yonghua. Clinical Comparative Study between Laparoscopy and Open Surgery in the Radical Treatment of Advanced Gastric Cancer. West China Medical Journal, 2011, 26(9): 1323-1326. doi: Copy
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