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老年胃癌患者腹腔镜根治性胃切除术与传统开放手术:益处与并发症

Laparoscopic radical gastrectomy versus traditional open surgery in elderly patients with gastric cancer: Benefits and complications.

作者信息

Li Hongtao, Han Xiaopeng, Su Lin, Zhu Wankun, Xu Wei, Li Kun, Zhao Qingchuan, Yang Hua, Liu Hongbin

机构信息

Department of General Surgery, General Hospital of Lanzhou Military Region, Lanzhou, Gansu 730050, P.R. China.

Xijing Hospital of Digestive Disease, The Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China.

出版信息

Mol Clin Oncol. 2014 Jul;2(4):530-534. doi: 10.3892/mco.2014.283. Epub 2014 Apr 28.

Abstract

This study was conducted to compare the therapeutic effect and complications of laparoscopic radical gastrectomy (LRG) with those of traditional open surgery in elderly patients with gastric cancer (GC). We conducted a retrospective comparison of therapeutic efficacy and complications between elderly patients with GC (defined as those aged ≥70 years) who received laparoscopic gastrectomy and those who underwent gastrectomy by open surgery. A total of 108 patients who either underwent laparoscopic surgery (n=54) or traditional open surgery (n=54) at the General Hospital of Lanzhou Military Region between June, 2008 and March, 2009 were analyzed. Compared to traditional open surgery, LRG exhibited several advantages, such as being less invasive, with less intraoperative blood loss, shorter bedbound time, less intubation time, low frequency of fever, less time to normal diet, shorter hospital stay and a low overall incidence of complications. No significant difference was observed between laparoscopic and open surgery in terms of operative time and number of lymph nodes dissected. The 3-year cancer recurrence and mortality rates were similar in the two groups. In conclusion, LRG is a safe and effective procedure for the management of GC in elderly patients and was found to be superior to traditional open surgery regarding the short-term curative effect. Therefore, LRG represents a feasible and safe surgical approach for elderly patients with GC.

摘要

本研究旨在比较腹腔镜根治性胃切除术(LRG)与传统开放手术对老年胃癌(GC)患者的治疗效果及并发症情况。我们对接受腹腔镜胃切除术的老年GC患者(定义为年龄≥70岁)和接受开放手术胃切除术的患者的治疗效果及并发症进行了回顾性比较。分析了2008年6月至2009年3月期间在兰州军区总医院接受腹腔镜手术(n = 54)或传统开放手术(n = 54)的108例患者。与传统开放手术相比,LRG具有一些优势,如创伤较小、术中出血量较少、卧床时间较短、插管时间较短、发热频率较低、恢复正常饮食时间较短、住院时间较短以及并发症总发生率较低。腹腔镜手术与开放手术在手术时间和清扫淋巴结数量方面未观察到显著差异。两组的3年癌症复发率和死亡率相似。总之,LRG是治疗老年GC患者的一种安全有效的方法,并且在短期疗效方面优于传统开放手术。因此,LRG是老年GC患者一种可行且安全的手术方式。

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