腹腔镜探查在进展期胃癌术前精准分期中的价值

Clinical value of laparoscopy in preoperative accurate staging of advanced gastric cancer

摘要:

目的 探讨腹腔镜探查在进展期胃癌术前分期的准确率及其在手术治疗中的临床应用价值。方法 回顾性分析2014 年1 月-2017 年4 月经该院病理科证实的进展期胃癌患者85 例临床资料。其中40 例进行 腹腔镜探查，45 例进行传统手术探查，比较2 种不同方法对进展期胃癌术前TNM 分期的准确率、胃癌转移 及预后情况。结果 对进展期胃癌T 分期准确率腹腔镜探查高于传统手术探查（P <0.05）；对进展期胃癌N 分 期准确率腹腔镜探查高于传统手术探查（P <0.05）。腹腔镜探查对进展期胃癌腹膜转移和隐性腹腔转移发现 率高于传统开腹探查（P <0.05）；腹腔镜探查组预后好于传统方法组（P <0.05）。结论 腹腔镜探查有助于术前 精准分期，能够避免一些不必要的开- 关腹手术，对进展期胃癌患者的治疗方案具有指导意义，有助于提高预 后效果。

Abstract:

Objective To study the accuracy of laparoscopy in preoperative staging of advanced gastric cancer and its clinical value. Methods A retrospective analysis of 85 cases with advanced gastric cancer in our hospital from March 2014 to March 2017 was carried out. Forty of them received laparoscopic surgery (laparoscopic surgery group) while the rest had traditional surgical treatment (traditional surgery group), and the accuracy of preoperative TNM staging, metastasis and prognosis of advanced gastric cancer were compared between these two groups. Results The accuracy rates of T staging, N staging for advanced gastric cancer of laparoscopic surgery group were significantly higher than those of the traditional surgery group (P < 0.05); the detection rates of peritoneal metastasis and recessive peritoneal metastasis of laparoscopic surgery group were significantly higher than those of the traditional surgery group (P < 0.05); the efficacy of laparoscopic surgery group was significantly higher than that of the traditional surgery group (80.0% vs 57.8%) (P < 0.05). Conclusion Laparoscopy is helpful for accurate preoperative staging and avoiding unnecessary open - abdominal surgery. It is of guiding significance for the treatment of advanced gastric cancer and has a good effect in the prognosis.