石磊

[摘要] 目的 探讨分析比较腹腔镜D2根治术与传统开腹术治疗胃癌的近期和远期临床疗效。方法 方便选取2012年5月—2013年5月该院收治的168例胃癌患者，根据入院时间分为对照组84例与观察组84例，对照组接受传统开腹治疗，观察组采用腹腔镜D2根治术治疗，观察分析两组远期、近期疗效。 结果 观察组淋巴结清扫数量与对照组比较差异无统计学意义（t=0.955，P>0.05）。观察组胃肠道蠕动恢复时间、术中出血量、手术时间、切口长度等指标均显然低于对照组（t=3.394、11.158、17.039、51.202，P<0.05）。观察组84例患者经治疗后第1年、第3年及第5年总生存率与对照组比较差异无统计学意义（χ2=0.099、0.272、0.135，P>0.05）。结论 相比于传统开腹手术治疗胃癌，腹腔镜D2根治术近期疗效更佳，但两者远期疗效比较基本一致。

[关键词] 胃癌；腹腔镜D2根治术；传统开腹手术；疗效

[中图分类号] R735 [文献标识码] A [文章编号] 1674-0742（2017）12（a）-0056-03

[Abstract] Objective To study and analyze the short-term and long-term clinical curative effect of laparoscopic D2 radical surgery and traditional laparotomy in treatment of gastric cancer. Methods 168 cases of gastric cancer patients admitted and treated in our hospital from May 2012 to May 2013 were conveniently selected and divided into two groups with 84 cases in each according to the admission time， the control group adopted the traditional laparotomy， while the observation group adopted the？laparoscopic D2 radical surgery， and the short-term and long-term curative effects of the two groups were observed and analyzed. Results The difference in the number of lymph node dissection between the two groups was not statistically significant （t=0.955， P>0.05）， and the gastrointestinal peristalsis recovery time， intraopertive bleeding amount， operation time and cut length were obviously lower than those in the control group （t=3.394，11.158，17.039，51.202，P<0.05）， and the differences in the total survival rates in the first year， third year and fifth year between the two groups were not statistically significant（χ2=0.099，0.272，0.135， P>0.05）. Conclusion The short-term curative effect of laparoscopic D2 radical surgery is better than that of traditional laparotomy is better， but the long-term curative effect is basically consistent.

[Key words] Gastric cancer； Laparoscopic D2 radical surgery； Traditional laparotomy； Curative effect

胃癌是临床中常见恶性肿瘤疾病，其具有较高病发率、死亡率；临床中以手术治疗疗为主要治疗手段。随着医疗技术的发展，胃癌患者手术治疗可分为传统开腹手术与腹腔镜下D2根治术两种。传统开腹手术治疗虽然具备良好疗效，但该方法对患者具有较大创伤性、术后并发症发生率较高、存在较大危险因素，并不适用于免疫力较差或老年患者。腹腔镜辅助治疗具有创伤小、术后恢复快、并发症少等优点，被广泛应用与临床中[1]。但其临床报道较少，且对腹腔镜手术治疗胃癌远期、近期疗效仍然处于探索阶段。该次研究方便选取2012年5月—2013年5月该院收治的168例胃癌患者作为研究对象，探究分析两种不同治疗方式的远期及近期疗效比较，现报道如下。