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目的:探讨腹腔镜辅助根治术用于胃癌伴肥胖患者的可行性及安全性。方法:按研究对象的选择标准,对我院2012年12月至2013年12月收治的胃癌伴肥胖患者予以筛选,选取符合标准的76例为研究对象。采用随机数字表法将其分为观察与对照组,观察组40例,采用腹腔镜辅助根治术;对照组36例,采用开腹手术。对比分析两组手术时间、术中出血量、清扫淋巴结数量、术中并发症、疗效、术后并发症、术后康复时间、治疗依从率等。结果:观察组手术时间、淋巴结清扫数量与对照组差异无统计学意义(P>0.05),出血量、切口长度、术后并发症发生率、排气时间、进食时间、出院时间等均优于对照组,差异有统计学意义(P<0.05);观察组总有效率为87.5%,对照组为88.9%,两组差异无统计学意义(P>0.05);观察组完全依从22例,依从16例,不依从2例,治疗依从率为95.0%,高于对照组的72.2%(P<0.05)。结论:腹腔镜辅助根治术用于胃癌伴肥胖患者具有出血少、并发症发生率低、疗效显著、依从性高等优势,安全可行。
Objective: To investigate the feasibility and safety of laparoscopic-assisted radical mastectomy for gastric cancer with obesity. Methods: The gastric cancer patients with obesity who were admitted from December 2012 to December 2013 in our hospital were screened according to the selection criteria of the research object. 76 eligible patients were selected as the research object. Using random number table method, it was divided into observation and control group, observation group 40 cases, laparoscopic-assisted radical mastectomy; control group 36 cases, using laparotomy. The operative time, intraoperative blood loss, lymph node count, intraoperative complications, curative effect, postoperative complications, postoperative recovery time and treatment compliance rate were compared between the two groups. Results: There was no significant difference between the observation group and the control group (P> 0.05), the amount of bleeding, incision length, the incidence of postoperative complications, exhausting time, eating time and discharge time were all better than those in the control group (P <0.05). The total effective rate was 87.5% in the observation group and 88.9% in the control group, with no significant difference between the two groups (P> 0.05). The observation group completely complied with 22 cases and followed the compliance 16 cases did not comply with the 2 cases, the treatment compliance rate was 95.0%, higher than 72.2% of the control group (P <0.05). Conclusions: Laparoscopic assisted radical surgery is safe and feasible for patients with gastric cancer and obesity who have less bleeding, low complication rate, significant curative effect and high compliance.