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目的比较3D腹腔镜远端胃癌D2根治术与传统2D腹腔镜远端胃癌D2根治术的临床疗效。方法回顾性分析2014年12月至2016年12月解放军总医院普通外科行远端胃癌D2根治术的135例患者的临床资料。观察组65例,行3D腹腔镜远端胃癌D2根治术;对照组70例,行传统2D腹腔镜远端胃癌D2根术;比较两组的手术时间、进流食时间、术中出血量、术后首次下床时间、住院时间、淋巴结清扫数等,比较3D与传统2D的近期临床效果。结果两组患者的性别及年龄等基本资料比较,差异无统计学意义(P>0.05)。手术时间:观察组(212.4±40.2)min,对照组(244.6±30.1)min,差异有统计学意义(P<0.001);进流食时间:观察组(43.8±5.3)h,对照组(55.1±7.5)h,差异有统计学意义(P=0.019);术中出血量:观察组(47.9±11.2)ml,对照组(83.4±15.3)ml,差异有统计学意义(P<0.001);术后首次下床时间:观察组(1.01±0.42)d,对照组(1.76±0.39)d,差异有统计学意义(P=0.026);住院时间:观察组(7.6±1.7)d,对照组(10.4±1.9)d,差异有统计学意义(P=0.032)。淋巴结清扫数:观察组(34.7±8.2)枚,对照组(24.2±8.1)枚,差异无统计学意义(P=0.083)。两组的术后并发症发生率比较,差异无统计学意义。结论 3D腹腔镜远端胃癌D2根治术具有手术创伤小、术后恢复快的优点,安全可行,近期临床效果显著。
Objective To compare the clinical efficacy of D2 radical mastectomy of 3D laparoscopic distal gastric cancer with D2 radical mastectomy of traditional 2D laparoscopic distal gastric cancer. Methods The clinical data of 135 patients with distal gastric cancer D2 radical resection from December 2014 to December 2016 in the General Surgery General Hospital of PLA were retrospectively analyzed. In the observation group, 65 cases were treated with D2 laparoscopic distal gastric cancer D2. The control group was treated with D2 laparoscopic distal gastric cancer. The operation time, inflow time, intraoperative blood loss, After the first bed time, hospital stay, lymph node dissection number, 3D and traditional 2D compared the recent clinical results. Results There was no significant difference in the basic data such as gender and age between the two groups (P> 0.05). The duration of operation was (212.4 ± 40.2) min in the observation group (244.6 ± 30.1) min and the difference was statistically significant (P <0.001). The feeding time to the observation group (43.8 ± 5.3) h and the control group (55.1 ± 7.5) h, the difference was statistically significant (P = 0.019); the amount of blood loss in the observation group (47.9 ± 11.2) ml and the control group (83.4 ± 15.3) ml, the difference was statistically significant The time of first outgrowth in the observation group (1.01 ± 0.42) d and the control group (1.76 ± 0.39) d, the difference was statistically significant (P = 0.026); The length of stay in the observation group (7.6 ± 1.7) d, 10.4 ± 1.9) d, the difference was statistically significant (P = 0.032). The number of lymph node dissection: the observation group (34.7 ± 8.2) pieces, the control group (24.2 ± 8.1) pieces, the difference was not statistically significant (P = 0.083). The incidence of postoperative complications between the two groups, the difference was not statistically significant. Conclusion D2 laparoscopic distal gastric cancer with less surgical trauma, postoperative recovery advantages, safe and feasible, the recent clinical results were significant.