目的：分析腹腔镜辅助下D2根治术治疗进展期胃癌的效果。方法选取2012年6月~2015年6月陕西省榆林市第二医院普外科收治的120例进展期胃癌患者，按照住院单双号将其分为两组，观察组（61例）行腹腔镜辅助下D2根治术治疗，对照组（59例）行传统开腹手术治疗。观察并记录两组患者围术期指标、健康调查简表（SF-36）各项评分、肿瘤根治有效性及随访12个月期间并发症发生情况，以评价腹腔镜辅助下D2根治术治疗进展期胃癌的效果。结果观察组手术时间、手术切口长度、术中出血量、住院时间均明显短于或少于对照组（P<0.05）。术后12个月，两组SF-36各项评分均较术前显著提高（P<0.05），且观察组躯体疼痛和总体健康评分明显高于对照组（P<0.05）。术后两组清扫淋巴结总数差异无统计学意义（P>0.05）。两组肿瘤距远切缘及近切缘的距离比较，差异无统计学意义（P>0.05）。随访期间，观察组并发症发生率明显低于对照组（P<0.05）。结论腹腔镜辅助下D2根治术治疗进展期胃癌能有效清除病灶区淋巴结，提高术后生活质量，且手术时间短，切口小，出血量少，安全性较传统开腹手术高，值得临床推广应用。%Objective To analyze the efficacy of laparoscopic-assisted D2 radical total gastrectomy in the treatment of advanced gastric cancer. Methods One hundred and twenty cases of patients with advanced gastric cancer admitted to Department of General Surgery of Yulin Second Hospital from June 2012 to June 2015 were selected, and they were di-vided into two groups according to odd-even number of hospitalization. The observation group (61 cases) was given la-paroscopic-assisted D2 radical total gastrectomy, the control group (59 cases) was given traditional laparotomy. The pe-rioperative parameters, the MOS item short from health survey (SF-36) scores, effectiveness of radical treatment for tu-mour and complications during 12 months follow-up in the two groups were observed and recorded, so as to evaluate the efficacy of laparoscopic-assisted D2 radical total gastrectomy in the treatment of advanced gastric cancer. Results The surgery time, incision length, intraoperative blood loss, hospital stay of the observation group were all shorter or less than those of the control group (P<0.05). After operation for 12 months, the SF-36 scores of two groups were all increased compared with those before operation (P<0.05), and the scores of pain and health in the observation group were all higher than those of the control group (P< 0.05). There was no statistically significant difference on the total number of lymph nodes removed between the two groups (P> 0.05). The distance of tumor to distal margin and tumor to proximal margin between the two groups had no statistically significant differences (P>0.05). During follow-up, the incidence of complications in the observation group was lower than that of the control group (P< 0.05). Conclusion Laparoscopic-assisted D2 radical total gastrectomy in the treatment of advanced gastric cancer can significantly remove the lymph nodes, improve postoperative quality of life, and the operation time is short, the incision is small, the blood loss is less, the safety is better than traditional laparotomy, which is worthy of clinical promotion and application.
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