Objective To investigate the surgical time and improvement of postoperative indexes for the treatment of upper stomach cancer with laparoscopic total gastrodin D2 radical resection. Methods 96 patients with upper stomach cancer were selected and divided into observation group (n = 47) and control group (n = 49) combined with surgical indications and personal wishes. The patients in the observation group underwent laparoscopic total gastrectomy with D2, while the control group underwent open surgery. The operative time, intraoperative blood loss, lymphatic clearance, first feeding time, first exhaust time, hospitalization time, and complications were compared between the two groups. Results The operating time for the patients in observation group was (229. 53 ± 24. 47) min, significantly longer than (210. 96 ± 22. 85) min in the control group, the intraoperative blood loss in the patients of observation group was (71. 61 ± 18. 90) m L, which significantly lower than (127. 63 ± 24. 07) m L in the control group, the differences was statistically significant (P ＜ 0. 05). The difference of the number of lymph nodes for the patients in two groups compared was no statistical significance (P＞ 0. 05). Compared with the control group, the first meal time, the first exhaust time, hospitalization time in the patients in observation group were significant shorter (P ＜ 0. 05). The rate of complications in the patients in observation group was 6. 39％, the control group was 20. 41％, the complication rate in observation group was much lower than that in the control group (P ＜ 0. 05). Conclusion To use the laparoscopic gastric D2 radical treat the patients with upper stomach cancer based on the basic of strictly grasp the operation indication, although with longer operation time but less blood loss, fewer complications, and postoperative indicators are rapidly improved after surgery, it is worthy to popularize and apply in clinical use.%目的 探讨腹腔镜全胃D2根治术治疗胃上部癌的手术时间和术后指标的改善情况.方法 选取胃上部癌患者96例,结合患者手术适应证和个人意愿分为观察组(n=47)和对照组(n=49).观察组患者行腹腔镜全胃D2根治术,对照组则行开腹手术.比较2组患者手术时间,术中出血量,淋巴清除数量,首次进食时间,首次排气时间,住院时间以及并发症的发生情况.结果 观察组患者手术时间为(229.53±24.47)min,明显长于对照组的(210.96±22.85)min,差异统计具有统计学意义(P ＜0.05).观察组患者术中出血量为(71.61±18.90)m L,明显少于对照组的(127.63±24.07)m L,差异具有统计学意义(P ＜0.05).2组患者淋巴清除数量差异比较无统计学意义(P＞ 0.05).与对照组相比,观察组首次进食时间,首次排气时间及住院时间均较短(P ＜0.05).观察组并发症的发生率明显低于对照组(P ＜0.05).结论 腹腔镜全胃D2根治术治疗胃上部癌患者,在严格掌握手术适应证的前提下,手术时间虽然较长但术中出血量小,并发症少,患者术后指标均迅速得以改善,是临床值得推广的术式.
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