比较完全腹腔镜、腹腔镜、开腹三种根治术式治疗进展期胃癌的围术期疗效及安全性。

回顾性分析2013年3月至2015年3月120例进展期胃癌患者资料，根据术式不同分为三组，完全腹腔镜组、腹腔镜组和开腹组，每组各40例。采用SPSS20.0软件进行统计学分析，围术期相关指标的描述以(±s)的形式，两组间采用t检验，三组间采用F检验分析；术后并发症、随访1年内的复发率、转移率和病死率采用χ²检验分析。P<0.05差异有统计学意义。

三组的淋巴结清扫数和手术时间差异无统计学意义(P>0.05)；完全腹腔镜组术中出血量、术后镇痛时间和术后住院时间均明显低于开腹组(P<0.05)，但与腹腔镜组差异无统计学意义(P>0.05)；而术后下床时间与消化道重建时间则均明显少于开腹组与腹腔镜组(P<0.05)；三组患者术后并发症发生率和1年内复发、转移与死亡率差异均无统计学意义(P>0.05)。

完全腹腔镜胃癌根治术具有恢复快、创伤小、疼痛感轻、安全可靠等优势，近期疗效较好，值得临床推广应用。

To investigate the perioperative efficacy and safety of complete radical laparoscopic, laparoscopic, and open radical surgery for advanced gastric cancer.

120 cases of advanced gastric cancer treated in our hospital from March 2013 to March 2015 were retrospectively analyzed. According to the different operative methods, they were divided into three groups: complete laparoscopic group, laparoscopic group, and open group, with 40 cases in each group. SPSS20.0 software was used to statistically analyze. The perioperative efficacy-related indicators and other measurement data were described in the form of(±s), and compared with t tests between the two groups, and F tests among the three groups. Postoperative complications and recurrence within 1 year after follow-up were performed. Counting data such as metastasis, survival, etc. were analyzed using the χ² test. When P<0.05, the difference was statistically significant.

There was no significant difference in lymph node dissection and operation time between complete laparoscopic group, laparoscopic group and laparotomy group (P>0.05). The intraoperative blood loss, postoperative analgesia time, and postoperative hospital stay in the complete laparoscopic group were significantly lower than those in the open group (P<0.05), but there was no significant difference between the complete laparoscopic group and the laparoscopic group (P>0.05). The postoperative bedtime and gastrointestinal reconstruction time in the complete laparoscopic group were significantly lower than those in the open group and laparoscopic group (P<0.05). There were no significant differences in the incidence of postoperative complications among the three groups (P>0.05). There was no significant difference in the recurrence, metastasis and death among the three groups within one year (P>0.05).

Complete laparoscopic radical gastrectomy has the advantages of rapid recovery, less trauma, less pain, and safety and reliability. The recent curative effect is better. It is worth further promotion and application.