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腹腔镜辅助胃癌根治术在老年患者中的应用研究 被引量：15

Study on the application of laparoscopy-assisted radical gastrectomy for gastric cancer in the elderly
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摘要 目的探讨腹腔镜辅助胃癌D：根治术在老年患者应用中的可行性及临床疗效。方法回顾性分析2007年10月至2012年10月间在河南大学淮河医院接受腹腔镜辅助胃癌根治术的109例老年（70岁以上）进展期胃癌患者（腹腔镜组）的临床资料，并与同期开腹胃癌根治术的124例老年患者（开腹组）的临床资料进行对比分析。结果与开腹组相比，腹腔镜组患者术中出血量更少[（102．5±34．3）ml比（181．7±73．8）ml，P〈0．05]，术后肠功能恢复更快[（2．8±0．6）d比（4．0±1．2）d，P〈0．05]，术后住院时间更短[（10．7±7．5）d比（14．2±6．5）d，P〈0．05]，术后并发症发生率更低[10．1％（11／109）比21．0％（26／124），P〈0．05]，但手术时间较长[（231．2±51．4）min比（208．5±53．6）min，P〈0．05]，两组患者淋巴结清扫枚数相当（31．4±14．2比32．6±11．7，P〉0．05）。腹腔镜组术后短期生活质量明显优于开腹组（P〈0．05）。腹腔镜组和开腹组术后5年生存率分别为54．5％和59．2％，差异无统计学意义（P〉0．05）。结论老年患者行腹腔镜辅助胃癌根治术能达到与开腹手术相似的根治效果，且微创优势显著。 Objective To evaluate the feasibility and efficacy of laparoscopy-assisted D2 radical gastrectomy for elderly patients with gastric cancer. Methods From October 2007 to October 2012, 233 gastric cancer patients over 65 years underwent D2 lymph node dissection. Among them, 109 patients underwent laparoseopy-assisted radical gastrectomy （LAG group）, while 124 patients underwent conventional open gastreetomy （OG group）. Results Compared to the OG group, LAG group was associated with less bleeding [ （102.5±34.3） ml vs. （ 181.7±73.8） ml, P〈0.05 ], quicker postoperative recovery of bowel function [（2.8±0.6） d vs. （4.0±1.2） d, P〈0.05], shorter postoperative length of hospital stay [（10.7±7.5） d vs.（14.2±6.5） d, P〈0.05], longer operative time [（231.2±51.4） min vs. （208.5±53.6） min, P〈0.05]. The postoperative complication rate of LAG group and OG group was 10.1% （11/109） and 21.0% （26/124） respectively （P〈0.05）. Short-term quality of life of LAG group was better than that of OG group （P〈0.05）. The 5-year survival rates were 54.5% and 59.2% in LAG and OG groups respectively, and there was no significant difference（P〉0.05）. Conclusions Efficacy of laparoscopy-assisted D2 radical gastrectomy is similar to open gastrectomy in elderly gastric cancer patients with less invasiveness.
作者 胡军红 杨德生 郑立 李诗杰 王晨宇 任学群
机构地区 河南大学淮河医院普通外科
出处 《中华胃肠外科杂志》 CAS CSCD 2013年第11期1092-1095,共4页 Chinese Journal of Gastrointestinal Surgery
基金 卫生部“肿瘤微创手术治疗规范化研究”课题（W2013K67） 河南大学科技攻关项目（2011YBZR040）
关键词 胃肿瘤 老年人 胃切除术 腹腔镜 预后 Stomach neoplasms Elderly Gastrectomy Laparoscopy Prognosis
分类号 R735.2 [医药卫生—肿瘤]
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参考文献12

  • 1孟春燕,林建贤,黄昌明,郑朝辉,李平,谢建伟,王家镔.腹腔镜辅助胃癌根治术在老年人胃癌中的应用[J].中华胃肠外科杂志,2012,15(2):152-156. 被引量：33
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二级参考文献13

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  • 8Hiki N,Shimoyama S,Yamaguchi H,et al.Laparoscopyassisted pylorus- preserving gastrectomy with quality controlled lymph node dissection in gastric cancer operation.J Am Coll Surg,2006,203(2):162-169.
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共引文献312

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引证文献15

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中华胃肠外科杂志
2013年 第11期

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