目的:对比观察进展期胃癌不同术式的疗效差异.方法:选取2011年9月~2014年5月我院普外科168例进展期胃癌进行研究,随机分为观察组87例和对照组81例,观察组接受腹腔镜辅助胃癌D2根治术,对照组接受开腹下胃癌D2根治术.分析比较两组患者的术中、术后情况及免疫功能的差异.结果:腹腔镜组的术中出血量、手术切口长度,术后引流量、下地时间、住院时间以及镇痛泵使用时间均较开腹组少或短,并且腹腔镜组的免疫抑制较轻微(均P<0.05),但其手术时间较开腹组长(P<0.05);此外,两组的淋巴结清扫数目及术后并发症发生率组间比较差异并不显著(均P>0.05).结论:腹腔镜胃癌D2根治术较传统开腹手术具有术中出血量少、手术切口短,术后引流量少、手术切口愈合快、胃肠功能恢复迅速、疼痛缓解快,免疫抑制轻微等优点.%Objective: To observe the difference of the therapeutic effects of different surgical methods in the treatment of advanced gastric cancer.Methods:A total of Sep 2011 to may 2014 in general surgery department of our hospital 168 cases of advanced gastric cancer study,were randomly divided to observation group (87 cases) and control group (81 cases),observation group received laparoscopic-assisted resection of gastric D2, the control group received laparotomy D2 resection of gastric cancer. Analysis and comparison of the two groups of patients with intraoperative and postoperative conditions and differences in immune function.Results:The laparoscopic group blood loss,incision length,postoperative drainage,ambulation time,length of hospital stay and analgesia compared with less time or short open group, and immunosuppression minor laparoscopic group (both P<0.05), but the head of the surgical time than open surgery (P<0.05);in addition,the difference between the two groups in the number of lymph node dissection and postoperative morbidity groups was not significant (all P>0.05).Conclusion:Laparoscopic gastric D2 resection than traditional open surgery has less blood loss, shorter incision,less postoperative drainage,surgical incision healing,rapid recovery of gastrointestinal function,pain relief fast, immunosuppression light, etc.
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