【摘要】 目的:比较腹腔镜与开腹胃癌根治术治疗老年进展期胃癌的近远期疗效、安全性及对免疫指标的影响。方法:回顾性分析96例70岁以上进展期胃癌患者的临床资料,其中52例接受开腹胃癌根治术(OG组),44例接受腹腔镜胃癌根治术(LG组),比较两组免疫指标、近远期疗效及安全性。结果:术后3 d,LG组CD3+、CD4+及CD8+均显著高于OG组(P<0.05),IL-2及IL-6显著低于OG组(P<0.05)。LG组并发症发生率13.7%,显著小于OG组32.7%(P<0.05)。随访15~60个月,两组术后相同时间的病死率、复发率、转移率均无统计学差异(P>0.05),但LG组中位生存时间37个月,长于OG组34个月(P<0.05)。结论:腹腔镜胃癌根治术治疗老年进展期胃癌,具有创伤小,安全性好,免疫功能损伤小的优点,近期疗效和中位生存期优于开腹术组。更多还原

【Abstract】 Objective To compare the long-term and short-term efficacy and safety and changes of immune indexes between laparoscopic-assisted and open radical gastrectomy for elderly patients with advanced gastric cancer. Methods The medical records and follow-up data of 96 patients over 70 years old with advanced gastric cancer were analyzed retrospectively, including 52 cases who received open radical gastrectomy(OG group) and 44 cases who received laparoscopic-assisted radical gastrectomy(LG group). Data were compared comprehensively between two groups, including immune indexes, long-term and short-term efficacy and safety. Results At 3 days after operation, CD 3 +、CD4+ and CD8+ in LG group were significantly higher than those in OG group(P <0.05), while IL-2 and IL-6 in LG group were significantly lower than those in OG group(P <0.05). The incidence of complications in LG group was13.7%, significantly less than that in OG group 32. 7 %(P < 0. 05). After 15 to 60 months follow-up, there were no statistical differences between the two groups of mortality, recurrence rate and transfer rate(P > 0. 05)at the same time. However,the median survival time in LG group was 37 months,longer than 34 months in OG group(P < 0. 05). Conclusion Laparoscopic radical treatment of gastric cancer has the advantages of small trauma, good safety and small immune function, and the recent curative effect and survival of the median are better than that of the open abdominal surgery group.更多还原