关键词: 腹腔镜, 开腹, 全胃切除术, D2淋巴结清扫术, 进展期胃癌, 近远期疗效

Abstract: 【Abstract】〓Objective〓To compare the clinical efficacy in short-term and long-term time of laparoscopic total gastrectomy vs..open total gastrectomy combined with D2 lymph node dissection respectively in the treatment of patients with advanced gastric carcinoma. Methods〓Clinical data of 228 patients with advanced gastric carcinoma in our hospital treated by radical total gastrectomy combined with D2 lymph node dissection were retrospectively analyzed, in which observation group underwent laparoscopic total gastrectomy combined with D2 lymph node dissection and control group underwent open total gastrectomy combined with D2 lymph node dissection. Comparisons of clinical efficacy in short-term and long-term time between two groups were conducted. Results〓The operative time in observation group was significantly longer than that in control group (P<0.05), and the intraoperative blood loss was less than that in control group (P<0.05). No statistical significance in the number of lymph nodes between groups was found. The first exhaust time, recovery time of gastrointestinal function and hospitalization time in observation group were shorter than those in control group, and the differences were statistically significant (all P values were less than 0.05). There was no statistical significance on difference of tumor proximal margin and hospitalization cost between two groups. The postoperative complication rate in observation group was lower than that in control group (7.89% vs. 18.42%, P<0.05). The average follow-up time was 2.86±1.81 years. The survival rate for 1 years, 3 years, 5 years without tumor between two groups was no statistical significance. The median survival time in observation group was 3.035 (95%CI: 2.683-3.386) years, and 2.856 (95%CI: 2.669-3.044) years in control group and there was no statistically significant (P>0.05). Conclusion〓Compared with open total gastrectomy combined with D2 lymph node dissection, laparoscopic total gastrectomy combined with D2 lymph node dissection for patients with advanced gastric carcinoma has characteristics of good short-term clinical efficacy, high safety, and high long-term survival rate.

Key words: Laparoscopic, Open, Total gastrectomy, D2 lymph node dissection, Advanced gastric carcinoma, Short-term and long-term clinical efficacy