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目的比较分析腹腔镜与开腹手术行胃癌D2根治术的近期临床疗效和安全性。方法按照随机双盲的原则将因胃癌住院手术治疗的患者104例分成对照组和试验组,各52例。两组患者均采用胃癌D2根治术,对照组患者采用开腹手术、试验组患者采用腹腔镜手术,比较两组患者手术切口长度、出血量、手术时间、住院天数、清除淋巴结数量以及术后并发症发生率。结果试验组平均手术切口长度少于对照组,两组差异具有统计学意义(P<0.05);试验组平均出血量少于对照组,两组差异具有统计学意义(P<0.05);试验组平均手术时间多于对照组,两组差异无统计学意义(P>0.05);试验组平均住院天数少于对照组,两组差异具有统计学意义(P<0.05);试验组平均清除淋巴结数量少于对照组,两组差异无统计学意义(P>0.05);试验组术后并发症发生率低于对照组,两组差异具有统计学意义(P<0.05)。结论腹腔镜行胃癌D2根治术与开腹行胃癌D2根治术比较具有手术出血少、切口长度小、住院天数少和术后并发症少的技术优势,而在手术时间和淋巴结清除上,开腹手术与腹腔镜手术比较并没有优势可言,因此,腹腔镜行胃癌D2根治术是胃癌治疗的一种创伤小、恢复快、安全性高的方法 ,具有广泛的应用前景。
Objective To compare and analyze the short-term clinical efficacy and safety of laparoscopic and open surgery in the treatment of D2 gastric cancer. Methods According to the principle of randomized double-blind, 104 cases of gastric cancer hospitalized patients were divided into control group and experimental group, with 52 cases in each group. Two groups of patients were treated with D2 radical gastrectomy, the control group of patients underwent laparotomy. The patients in the experimental group were treated with laparoscopic surgery. The length of incision, blood loss, operation time, days of hospitalization, lymph node clearance and postoperative complications The incidence of disease. Results The mean operative incision length in the experimental group was less than that in the control group, with significant difference between the two groups (P <0.05). The mean bleeding volume in the experimental group was less than that in the control group, with significant difference between the two groups (P <0.05) The average operation time was longer in the control group than in the control group, with no significant difference between the two groups (P> 0.05). The average length of stay in the experimental group was less than that in the control group (P <0.05) The difference between the two groups was not statistically significant (P> 0.05). The incidence of postoperative complications in the experimental group was lower than that in the control group, with significant difference between the two groups (P <0.05). Conclusions There is less technical advantage in D2 laparoscopic radical gastrectomy and open radical gastrectomy for D2 gastric cancer with less operation bleeding, shorter incision length, less hospitalization days and fewer postoperative complications. However, Compared with laparoscopic surgery there is no advantage at all, therefore, laparoscopic D2 gastric cancer treatment of gastric cancer treatment is a trauma, rapid recovery, high safety method, has a wide range of applications.