腹腔镜胃癌根治术与传统开腹手术在早期胃癌治疗中的应用效果比较

目的探讨腹腔镜胃癌根治术与传统开腹手术在早期胃癌治疗中的应用效果。方法依据手术方式将279例早期胃癌患者分为腹腔镜组(n=142)和开腹组(n=137),腹腔镜组患者接受腹腔镜胃癌根治术治疗,开腹组患者接受开腹胃癌根治术治疗。比较两组患者的围手术期相关指标、血清学指标血清癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]、生活质量和术后并发症发生情况。结果腹腔镜组患者手术时间明显长于开腹组患者,切口长度、首次进食时间、首次通气时间、首次排便时间、首次下床活动时间、住院时间均明显短于开腹组患者,术中出血量明显低于开腹组患者,差异均有统计学意义(P﹤0.01)。术后1天,两组患者血清CEA、CA19-9、CRP水平均低于本组术前,血清IL-6水平均高于本组术前,且腹腔镜组患者血清CRP、IL-6水平均低于开腹组患者,差异均有统计学意义(P﹤0.05)。术后6、12个月,两组患者欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)量表评分均高于本组术前,且腹腔镜组患者EORTC QLQC30量表评分均高于开腹组患者,差异均有统计学意义(P﹤0.05)。腹腔镜组患者术后并发症总发生率为5.63%,低于开腹组患者的13.87%,差异有统计学意义(P﹤0.05)。结论腹腔镜胃癌根治术与传统开腹胃癌根治术治疗早期胃癌的疗效相当,但腹腔镜手术更具微创性,有利于促进胃癌患者的术后恢复,降低术后炎性应激反应和并发症发生率,可提高患者的生活质量。

Comparison of the effect of laparoscopic radical gastric cancer surgery and traditional open surgery in the treatment of early gastric cancer

Objective To explore the application effect of laparoscopic radical gastic cancer surgery and traditional open surgery in the treatment of early gastic cancer.Method According to the surgical method,279 patients with early gastnc cancer were divided into a laparoscopic group(n=142)and an open group(n=137).Patients in the laparoscopic group received laparoscopic radical gastric cancer treatment,and patients in the open group received open radical gastric cancer treatment.Surgical treatment.The perioperative indicators and serological indicatorsserum carcmoembryomc antigen(CEA),carbohydrate antigen 19-9(CA19-9),C-reactive protein(CRP),interleukm-6(IL-6)],quality of life and postoperative complications.Result The operation time of laparoscopic group was significantly longer than that of open group,the incision length,first eating time,first ventilation time,first defecation time,first ambulation time and hospitalization time of laparoscopic group were significantly shorter than those of open group,the intraoperative blood loss was significantly lower than that of open group,the differences were statistically significant(P<0.01).1 day after operation,the serum levels of CEA,CA19-9,and CRP of the two groups were lower than those of the group before operation,and the levels of serum IL-6 were higher than those of the group before operation,and the levels of serum CRP and IL-6 in the laparoscopic group were lower than those in the open group,and differences were statistically significant(P<0.05).At 6 and 12 months after surgery,the European Organization for Research and Treatment of Cancer quality of life questionnaire core-30(EORTC QLQ-C30)scale of the two groups were higher than before operation,and the scores of the EORTC QLQ-C30 scale in the laparoscopic group were higher than those in the laparotomy group at 6 and 12 months after the operation,and the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the laparoscopic group was 5.63%,which was lower than the 13.87%in the laparotomy group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic radical gastric cancer resection is equivalent to traditional open radical gastric cancer radical resection for the treatment of early gastric cancer,but laparoscopic surgery is more minimally invasive,which is beneficial to promote the postoperative recovery of gastric cancer patients and reduce postoperative inflammatory stress and complications,and incidence rate can improve the quality of life of patients.