目的通过对比腹腔镜与开腹远端胃癌D2根治术的疗效及安全性,探讨腹腔镜辅助远端胃癌D2根治术的临床价值。方法 221例行远端胃癌D2根治术患者,分为两组。其中腹腔镜组115例,开腹组106例,对两组手术时间、术中出血量、术后排气时间、首次进流质时间、淋巴结清扫数目、术后住院天数、并发症进行比较。结果腹腔镜组手术时间、淋巴结清扫数与开腹组差异无统计学意义(P>0.05),而腹腔镜组术中出血量少,术后肛门排气时间早,首次进流质时间早,术后住院时间短,并发症发生率低(P<0.05)。结论腹腔镜辅助远端胃癌D2根治术具有创伤小、出血少、术后恢复快和并发症少等优点,近期疗效与开腹手术相当,安全可行,值得临床推广。 Objective To compare the efficacy and safety of D2 radical mastectomy for laparoscopic and open distal gastric cancer and explore the clinical value of laparoscopic-assisted D2 radical mastectomy for distal gastric cancer. Methods 221 cases of distal gastric cancer D2 radical surgery patients, divided into two groups. Among them, 115 cases were laparoscopic group and 106 cases were open group. The operation time, intraoperative blood loss, postoperative effusion time, the time of first entering the liquid, the number of lymph node dissection, postoperative hospital stay and complication were compared. Results The laparoscopic operation time, number of lymph node dissection and laparotomy group had no significant difference (P> 0.05), while the laparoscopic group had less bleeding, the time of anus venting was earlier, the time of the first admission was longer, After a short hospital stay, the complication rate was low (P <0.05). Conclusions Laparoscopic-assisted D2 distal radical gastrectomy has the advantages of less trauma, less bleeding, quick recovery and fewer complications. The short-term efficacy is equivalent to laparotomy and is safe and feasible. It is worthy of clinical promotion.