比较分析开腹胃癌根治术与腹腔镜胃癌根治术治疗老年胃癌的疗效
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摘要
目的观察比较在老年胃癌的临床治疗中分别运用开腹胃癌根治术与腹腔镜胃癌根治术治疗的效果。方法随机选取我院2015年7月~2017年7月收治的确诊为胃癌的老年患者88例,并按照手术方式的不同将其分为观察组与对照组,对照组42例,给予开腹胃癌根治术治疗;观察组46例,采用腹腔镜胃癌根治术。比较两组患者的临床疗效及术后并发症的发生情况。结果观察组第一次肛门排气时间、下床活动时间、住院时间、创口长度、术中出血量及止痛剂使用次数均显著优于对照组,差异有统计学意义(P<0.05)。两组淋巴结清扫数目及并发症的发生率的差异无统计学意义(P>0.05)。结论运用腹腔镜胃癌根治术对老年胃癌进行治疗,其手术时间虽较开腹胃癌根治术的时间长,但腹腔镜手术可取得与开腹手术相当的淋巴结清扫效果,且创口较小,出血少,同时不会增加术后并发症的发生,患者恢复快,值得推广应用于老年胃癌的临床手术治疗中。
Objective To observe the curative effect between open radical gastrectomy and laparoscopic radical gastrectomy for gastric cancer in elderly patients. Methods Eighty-eight cases of elderly patients with gastric cancer diagnosed in our hospital from July 2015 to July 2017 were randomly selected and divided into the observation group and the control group according to the different surgical methods.42 cases in the control group were treated with radical gastrectomy,and 46 cases in the observation group were treated with laparoscopic radical gastrectomy.The clinical efficacy and postoperative complications of the two groups were compared. Results The first time of anus exhaust,the time of disengagement,the length of hospitalization,the length of the wound,the amount of bleeding and the use of analgesics in the observation group were significantly better than those of the control group,and the differences were statistically significant(P < 0.05).There was no significant difference in the number of lymph node dissection and the incidence of complications between the two groups(P > 0.05). Conclusion Laparoscopic radical gastrectomy for the treatment of elderly gastric cancer,although the operation time is longer than the open radical gastrectomy of gastric cancer,but laparoscopic surgery can achieve the equivalent of the laparotomy lymph node dissection,and less wound,less bleeding,at the same time,it will not increase the incidence of postoperative complications,patients recover quickly,worthy of promotion and application.
Objective To observe the curative effect between open radical gastrectomy and laparoscopic radical gastrectomy for gastric cancer in elderly patients. Methods Eighty-eight cases of elderly patients with gastric cancer diagnosed in our hospital from July 2015 to July 2017 were randomly selected and divided into the observation group and the control group according to the different surgical methods.42 cases in the control group were treated with radical gastrectomy,and 46 cases in the observation group were treated with laparoscopic radical gastrectomy.The clinical efficacy and postoperative complications of the two groups were compared. Results The first time of anus exhaust,the time of disengagement,the length of hospitalization,the length of the wound,the amount of bleeding and the use of analgesics in the observation group were significantly better than those of the control group,and the differences were statistically significant(P < 0.05).There was no significant difference in the number of lymph node dissection and the incidence of complications between the two groups(P > 0.05). Conclusion Laparoscopic radical gastrectomy for the treatment of elderly gastric cancer,although the operation time is longer than the open radical gastrectomy of gastric cancer,but laparoscopic surgery can achieve the equivalent of the laparotomy lymph node dissection,and less wound,less bleeding,at the same time,it will not increase the incidence of postoperative complications,patients recover quickly,worthy of promotion and application.
引文
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[8]蒋晖,杜军,顾纪明,等.腹腔镜胃癌根治术与开腹胃癌根治术治疗老年胃癌疗效比较[J].新乡医学院学报,2016,33(9):770-773.
[9]吉国锋,季福建,马冲,等.腹腔镜辅助胃癌根治术治疗老年人胃癌临床疗效分析[J].中华老年医学杂志,2016,35(3):292-295.
[10]黄光琳.腹腔镜与开腹根治术对老年胃癌患者的临床疗效比较[J].中国现代普通外科进展,2016,19(8):654-655.
[11]王进超.进展期胃癌患者应用腹腔镜与开腹胃癌根治术治疗的临床疗效对比[J].现代消化及介入诊疗,2016,21(2):310-312.
[12]高子辰,高华,许新才,等.腹腔镜与开腹根治术治疗维吾尔族肥胖胃癌患者的临床疗效对比[J].中华胃肠外科杂志,2016,19(2):221-222.
[13]陈贵兵,徐晓倩,龚加庆,等.手辅助腹腔镜与开腹胃癌根治术安全性及疗效比较的Meta分析[J].中华胃肠外科杂志,2017,20(3):320-325.
[14]全信保,邹佩钢,杨学军,等.腹腔镜与开腹胃癌根治术对高龄胃癌患者免疫功能及近期疗效的对比研究[J].川北医学院学报,2017,32(1):46-48.
[15]徐凯,崔明,邢加迪,等.腹腔镜辅助胃癌根治术对老年胃癌患者的临床疗效分析[J].中国肿瘤临床,2017,44(16):800-804.
[16]董浩,柳小丽,唐鲁艳,等.老年患者腹腔镜与开腹胃癌根治术后医院感染对比分析[J].中华医院感染学杂志,2017,27(8):1806-1809.
[2]贾凯,马晋峰,樊臣杰.腹腔镜辅助胃癌根治术与开腹胃癌根治术对远端进展期胃癌的临床疗效对比研究[J].中国医药,2015,10(6):851-853.
[3]李益萍,王滢,崔琼,等.腹腔镜胃癌根治术治疗老年进展期胃癌的临床疗效[J].中华消化外科杂志,2015,14(3):195-199.
[4]仝德峰,刘江文,孙琳,等.进展期胃癌腹腔镜辅助D2根治术的临床疗效分析[J].中国普通外科杂志,2015,24(8):1201-1204.
[5]高金辉,李建国,蔡铭智,等.腹腔镜辅助与开腹胃癌根治术的中期疗效比较[J].中国微创外科杂志,2015,15(7):597-600.
[6]黄鑫,刘少壮,于斐,等.腹腔镜与开腹胃癌根治术的临床效果对比[J].腹腔镜外科杂志,2016,21(1):41-45.
[7]汪雪,王梦桥,汪树林.腹腔镜胃癌根治术治疗老年进展期胃癌的临床疗效分析[J].腹腔镜外科杂志,2016,21(10):733-736.
[8]蒋晖,杜军,顾纪明,等.腹腔镜胃癌根治术与开腹胃癌根治术治疗老年胃癌疗效比较[J].新乡医学院学报,2016,33(9):770-773.
[9]吉国锋,季福建,马冲,等.腹腔镜辅助胃癌根治术治疗老年人胃癌临床疗效分析[J].中华老年医学杂志,2016,35(3):292-295.
[10]黄光琳.腹腔镜与开腹根治术对老年胃癌患者的临床疗效比较[J].中国现代普通外科进展,2016,19(8):654-655.
[11]王进超.进展期胃癌患者应用腹腔镜与开腹胃癌根治术治疗的临床疗效对比[J].现代消化及介入诊疗,2016,21(2):310-312.
[12]高子辰,高华,许新才,等.腹腔镜与开腹根治术治疗维吾尔族肥胖胃癌患者的临床疗效对比[J].中华胃肠外科杂志,2016,19(2):221-222.
[13]陈贵兵,徐晓倩,龚加庆,等.手辅助腹腔镜与开腹胃癌根治术安全性及疗效比较的Meta分析[J].中华胃肠外科杂志,2017,20(3):320-325.
[14]全信保,邹佩钢,杨学军,等.腹腔镜与开腹胃癌根治术对高龄胃癌患者免疫功能及近期疗效的对比研究[J].川北医学院学报,2017,32(1):46-48.
[15]徐凯,崔明,邢加迪,等.腹腔镜辅助胃癌根治术对老年胃癌患者的临床疗效分析[J].中国肿瘤临床,2017,44(16):800-804.
[16]董浩,柳小丽,唐鲁艳,等.老年患者腹腔镜与开腹胃癌根治术后医院感染对比分析[J].中华医院感染学杂志,2017,27(8):1806-1809.