评价基于D2淋巴结清扫的两种术式治疗胃癌的近中期随访结果。

回顾性分析2015年4月至2019年5月接受D2淋巴结清扫术的83例胃癌患者病例资料，根据术式不同分为传统组(40例，传统开腹手术)和微创组(43例，腹腔镜D2淋巴结清扫术)。采用SPSS 23.0统计分析软件，手术相关指标、淋巴结清扫情况等计量资料以(±s)表示，采用独立样本t检验；并发症总发生率、术后3年生存率以率表示，采用χ²检验。P<0.05为差异有统计学意义。

微创组手术时间比传统组长，术后首次下床活动时间、术后排气时间、住院时间均比传统组短，术中出血量、切口长度均比传统组少，差异有统计学意义(P<0.05)。两组第一站及第二站淋巴结清扫数量、淋巴结清扫总数、术后3年生存率差异无统计学意义(P>0.05)。微创组术后并发症总发生率为7.0%低于传统组25.0%(P<0.05)。

与传统开腹手术相比，腹腔镜胃癌D2淋巴结清扫术治疗胃癌可减少对机体的创伤、加快术后康复进程，但在提高淋巴结清扫效果及术后生存率方面无明显优势。

To evaluate the results of near-to-mid-term follow-up of patients with gastric cancer who underwent two surgical procedures based on D2 lymph node dissection.

The clinical data of 83 patients with gastric cancer underwent D2 lymph node dissection from April 2015 to May 2019 were analyzed retrospectively . According to different surgical methods, 40 cases were divided into the traditional group who received the traditional laparotomy, while 43 cases were divided into the minimally invasive group who received the laparoscopic D2 lymph node dissection. Statistical analysis were performed by using SPSS 23.0 software. Measurement data such as the surgical related indexes and harvested lymph nodes were expressed as (±s), and were examined by using t test. The total incidence of complications and the 3-year survival rate were expressed as percentage, and were examined by using χ² tests. A P value of <0.05 was considered as statistically significant difference.

Compared with the traditional group, increased operation time, less blood loss, shortened incision length ambulation time postoperative exhausting time as well as hospitalizationtime were observed in the minimally invasive group (P<0.05). There were no significant differences between the two groups in terms of the number of D1, D2 and total harvested lymph nodes, as well as the 3-year survival (P>0.05). The incidence of postoperative complications of 7.0% in the minimally invasive group was lower than 25.0% in the traditional group (P<0.05).

In the surgical treatment of gastric cancer, compared with the traditional laparotomy, laparoscopic gastrectomy with D2 lymph node dissection could reduce the trauma to the body with enhanced postoperative recovery, however without obvious advantage in improving the lymph node dissection effect and postoperative survival.