王敬华

[摘要] 目的 探讨腹腔镜与开腹胃癌根治术治疗进展期胃癌的临床疗效。 方法 选取于2015年1月1日～2017年6月30日来我院就诊的进展期胃癌患者70例作为研究对象，依照入院次序进行分组，每组均35例，其中常规组采取开腹胃癌根治术治疗，实验组采取腹腔镜胃癌根治术治疗，将两组的相关参数进行分析对比。结果 实验组手术耗时长于常规组，但实验组的出血量、肛门排气时间、切口长度、下床时间、术后住院时间、首次进流食时间相比常规组均明显较低（P<0.05）；两组的淋巴结清扫数量与近远端切缘距离比较无明显差异（P>0.05）；实验组与常规组的并发症发生率分别为5.71%与22.86%（P<0.05）。 结论 对进展期胃癌患者采取腹腔镜胃癌根治术进行治疗效果显著，对患者造成的创伤较小，出血量较少，住院时间较短，利于术后身体恢复，值得采纳。

[关键词] 进展期胃癌；开腹胃癌根治术；腹腔镜

[中图分类号] R735.2 [文献标识码] B [文章编号] 1673-9701（2018）02-0043-03

[Abstract] Objective To investigate the clinical efficacy of laparoscopic and open radical gastrectomy in the treatment of advanced gastric cancer. Methods 70 patients with advanced gastric cancer who were admitted in our hospital from January 1， 2015 until June 30， 2017 were enrolled in this study. They were grouped according to the order of admission， with 35 cases in each group. The conventional group adopted open radical gastrectomy for gastric cancer， and the experimental group underwent laparoscopic radical gastrectomy for treatment. The relevant parameters of the two groups were analyzed and compared. Results The operation time of the experimental group was longer than that of the conventional group， but the bleeding volume， anal exhaust time， incision length， bed time， postoperative hospital stay and liquid food time at first time in the experimental group were significantly lower than those of the conventional group（P<0.05）. There was no significant difference between the two groups in the number of lymph node dissection and the distance between the proximal and distal margins（P>0.05）. The complication rates of the experimental group and the conventional group were 5.71% and 22.86%， respectively（P<0.05）. Conclusion The laparoscopic radical gastrectomy has obvious effect on patients with advanced gastric cancer， which causes less trauma to the patients， with less bleeding and shorter hospital stay， and is beneficial to the postoperative recovery of the body and worthy of adoption.

[Key words] Advanced gastric cancer； Open radical gastrectomy； Laparoscopy

胃癌在临床上较为常见，属于一类恶性肿瘤，该类患者发病初期的临床症状缺乏特异性，因此，难以进行及时有效的诊断，等到疾病确诊时多半为中晚期胃癌[1-2]。目前主要采取根治性手术进行治疗，随着近些年来微创技术的发展进步，腹腔镜技术广泛应用于胃癌的临床治疗中。许多研究指出[3]，腹腔镜胃癌根治术在早期胃癌疾病的治疗中可达到良好的治疗效果，肿瘤复发率较低，因此，许多学者认为可将其作为进展期胃癌患者的临床治疗方案，但是对其安全性、治疗效果仍存在一定的异议，为此，本次研究收治了70例进展期胃癌患者，现报道如下。

1 资料与方法

1.1 一般资料

选取于2015年1月1日～2017年6月30日来我院就诊的进展期胃癌患者70例作为研究对象，所有患者均被确诊，给予彩超、CT、胃镜等检查对病变部位进行明确，不存在远处转移情况，均为进展期胃癌患者，同时将淋巴結远处转移、早期胃癌、肝肾功能严重疾病、周围脏器浸润患者排除。……