目的: 探讨腹腔镜辅助远端胃癌根治术的临床疗效。方法: 回顾性比较2013年8月至2015年8月行腹腔镜辅助根治术(1aparoscopy-assisted gastrectomy,LAG)与开腹远端胃癌根治术(open gastrectoomy,OG)的资料,分别为LAG组与OG组,比较两组患者术后住院时间、术中出血量等资料。结果: 淋巴结清扫数目及肿瘤切缘距离,LAG组与OG组比较差异无统计学意义(P＞0.05);LAG组患者在术中的出血量为(167.6±34.5)mL,少于OG组的(215.7±42.1)mL(t=5.430,P=0.000);手术时间长于OG组(t=-2.905,P＜0.05);LAG组并发症发生率为12.8 %,OG组为22.2 %,两组比较差异无统计学意义(χ²=1.155,P=0.283);LAG组胃肠功能恢复时间为(57.9±7.9)h,短于OG组的(63.7±6.5)h(t=3.455,P＜0.05);LAG组平均住院时间为(11.4±4.3)d,短于OG组的(15.6±3.9)d(t=4.418,P=0.000)。LAG组与OG组局部复发率分别为7.69 %和8.33 %,两组比较差异无统计学意义(χ²=0.010,P=0.918)。;远处转移率分别为5.12 %和8.33 %,两组比较差异无统计学意义(χ²=0.309,P=0.578)。结论: 腹腔镜辅助根治术与开腹远端胃癌根治术疗效相当,但腹腔镜辅助根治术具有创伤小、出血少、术后恢复快等优点。

Objective: To explore the clinical effect of laparoscopic-assisted radical gastrectomy for distal gastric cancer.Methods:Clinical date of the gastric cancer patients who received 1aparoscopy-assisted gastrectomy (LAG) or open gastrectomy (OG) from August 2013 to August 2015 were reviewed and divided into LAG group and OG group.Results: There were no significant differences in the number of lymph node dissection and the distance of tumor margins between LAG group and OG group (P＞0.05); the intraoperative bleeding amount was (167.6 ± 34.5) mL in LAG group, which was less than (215.7 ± 42.1) mL in OG group (t=5.430,P=0.000); the operation time was longer than that in OG group (t= -2.905, P＜0.05); the complication rate was 12.8 % in LAG group and 22.2 % in OG group, which had no statistically significant difference between the two groups (χ²=1.155,P=0.283). The recovery time of gastrointestinal function in LAG group was (57.9 ±7.9) h, which was shorter than that in OG group (63.7 ± 6.5)h (t=3.455, P＜0.05); the average hospitalization time in LAG group was (11.4 ±4.3) d, shorter than that in OG group (15.6 ± 3.9) d (t=4.418, P=0.000). The local recurrence rates were 7.69 % and 8.33 % in LAG group and OG group respectively, and the difference between the two groups was not statistically significant (χ²=0.010, P=0.918); the distant metastasis rates were 5.12 % and 8.33 %, and the difference was not statistically significant (χ²=0.309, P=0.578).Conclusion: LAG has similar effects compared with OG in curing distal gastric cancer, but it has minimal trauma, less blood loss, and faster recovery.