腹腔镜辅助与开腹手术在治疗胃癌 并幽门梗阻中的疗效对比

Effect comparison between laparoscope and open surgery in treatment of gastric cancer with pyloric obstruction

摘要:

目的 分析腹腔镜辅助与开腹手术治疗胃癌并幽门梗阻患者的手术效果、术后恢复及近期并发症，探讨腹腔镜辅助治疗胃癌并幽门梗阻的安全性及可行性。 方法 该院2007年12月~2012年12月收治并手术治疗胃癌并幽门梗阻124例，根据患者意愿分为68例行腹腔镜辅助手术治疗（腹腔镜组）及56例行传统开腹手术治疗（开腹组），对两组患者的手术方式、术中及术后各项指标进行比较。 结果 腹腔镜组在术中出血量、切口长度、胃管滞留时间、首次进食时间、首次下床活动时间、术后胃肠功能恢复、术后3 d内疼痛数字评分（VAS）和总住院天数均优于开腹组（P <0.05），而在手术方式的选择、手术时间、切缘距肿瘤位置和淋巴结清扫数目上两组差异无显著性（P >0.05）。结论 腹腔镜辅助治疗胃癌并幽门梗阻是安全可行的，手术效果可以达到传统手术标准，同时具有创伤小、术后恢复快等优势。

Abstract:

【Objective】 To analyze the operation results, postoperative recovery and complications of gastric cancer with pyloric obstruction patient,which treated by laparoscopic or open surgery and to explore the feasibility and safety of laparoscopic or open surgery. 【Method】 Our hospital have received and cured 124 gastric cancer with pyloric obstruction patients from December 2007 and December 2012, 68 patients were treated by laparoscopy and 56 were treated by open surgery. The intraoperative and postoperative indicators between these two groups were compared . 【Results】 Under laparoscopy in blood loss, incision length,gastric residence time, for the first time to eat, the first ambulation time, postoperative recovery of gastrointestinal function, Visual Analog Scale (VAS), the total number of hospital days were better than the laparotomy group (P <0.05), but the difference in the choice of surgical approach, operative time, margin from the tumor location, number of lymph node dissection was not statistically significant (P >0.05). 【Conclusion】 Laparoscopic treatment of gastric cancer with pyloric obstruction is safe and feasible. The effect of laparoscopic can reach the traditional surgery standard with less trauma, faster postoperative recovery and other advantages.