目的：比较腹腔镜与传统开腹手术治疗胃癌的临床疗效并比较研究。方法选取本院2011年2月至2014年7月收治的胃癌患者62例，根据随机数字表法将所有患者随机平分为两组，分别采用腹腔镜胃癌根治术(观察组)治疗和传统开腹胃癌根治术(对照组)治疗，比较两组切口长度、手术时间、术中出血量、清扫淋巴结数量、胃肠道恢复时间、住院天数、术后并发症发生情况等。结果所有患者均受1~24个月随访，平均（13.57±4.93）个月。两组无肿瘤复发、转移病例，观察组术后吻合口漏1例，皮下气肿3例，淋巴漏1例，肠梗阻1例。对照组术后切口延迟愈合5例，切口感染4例，吻合口漏2例，引流管感染1例，肺部感染2例、肠梗阻3例。观察组术后切口长度、术中出血量、胃肠道恢复时间、住院天数均少于对照组，但手术时间长于对照组，比较具有统计学意义（P＜0.05），两组的淋巴结清扫数目大致相同，无统计学意义（P﹥0.05）见表1。观察组术后5天的CD3+、CD4+、CD8+、CD4+/CD8+、NK参数值高于对照组，术后免疫球蛋白IgG低于对照组，差异具有统计学意义（P＜0.05）。结论腹腔镜胃癌安全，创伤小、出血少、术后恢复快、并发症发生少，适合临床广泛应用。%Objective To compare clinical efficacy of laparoscopy and traditional laparotomy in the treatment of gastric cancer. Methods 62 patients with gastric cancer admitted to our hospital from Feb 2011 to July 2014 were retrospectively analyzed and randomly divided into two groups, laparoscopic radical gastrectomy group (observation group) and traditional laparotomy group (control group). Incision length, length of opera-tion, intraoperative blood loss, lymph nodes dissected, gastrointestinal recovery time, length of stay and postoperative complications between the two groups were compared. Results follow-up observation lasting 1-24 months with an average of 13.57 ±4.93 months was conducted to all the men-tioned patients. Tumor reoccurrence and metastasis were not observed in the two groups. There were 1 case of anastomotic leakage, 3 cases of subcuta-neous emphysema, 1 case of lymphatic fistula and 1 case of intestinal obstruction in the observation group and 5 cases of delayed postoperative heal-ing of incision, 4 cases of incision site infection, 2 cases of anastomotic leakage, 1 case of drainage tube infection, 2 cases of pulmonary infection and 3 cases intestinal obstruction in the control group. Incision length, intraoperative blood loss, gastrointestinal recovery time and length of stay in the ob-servation group were all less than those in control group but the length of operation of the observation group was longer, which showed significant dif-ference(P<0.05). The lymph node dissection numbers in the two groups were almost the same without significant difference(P>0.05). The postopera-tive values of CD3+、CD4+、CD8+、CD4 + /CD8 + and NK in the observation group were higher than those in control group while postoperative IgG was higher in control group, which were significantly different (P<0.05). Conclusion Laparoscopy has the advantage of being safe, minimal inva-sion, less blood loss, rapid postoperative recovery and fewer complications in the treatment of gastric cancer which is suitable for widespread clinical application.
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