| Gastric cancer is a common malignant tumor, and most of the patients were diagnosed as advanced gastric cancer. There are many different ways to treat gastric cancer, and of course they have different effect. Surgical treatment is the most popular method for the treatment of gastric cancer. With the development of modern medical science and technology, the development of minimally invasive surgery in laparoscopic technology as the representative of the rapid and has been applied widely in clinic, it was like opening a new chapter of clinical surgery. The advantages of laparoscopic technique for minimally invasive surgical treatment of gastric cancer give patients great hopes.Objective:To study and analysis the different effect of laparoscopic operation versus open operation for the treatment of advanced distal gastric cancer, and do the fellow-up, observe the quality of the patients" lives.Methods:From January,2011 to January,2014 there were 84 patients were diagnosed with advanced distal gastric cancer and treated in our hospital. According to the operation method of treatment, patients were divided into study group and control group,42 cases in each group, the study group was given laparoscopic operation treatment, and the control group was given traditional open operation treatment. After the surgery, we did the comparison and analysis of the patients with out comes and quality of lives.Results:The incision length and the amount of bleeding in study group have significantly better out comes than control group (P<0.05); The operating time and average number of lymph nodes dissection in the control group had no statistical significance (P> 0.05). In research group, the time of postoperative anal exhaust, begin meals, and hospitalization time was significantly earlier than control group (P<0.05). Intraperitoneal drainage at dayl,3, and 7 of study group was lower than the control group but no statistical significance (P>0.05). At dayl, 3, and 7 WBC levels of study group has statistical significance by comparing with the control group (P<0.05). Compared with pre-op and post-op, the level of APTT and 1NR of the study group and the control group have no significant change (P> 0.05); At the end of operation PT has no change with the two groups (P>0.05),24hrs after the operation, two groups of PT decreased with significant difference (P before operation< 0.05), but no significant difference between the two groups (P>0.05). Body weight, BMI index and other indicators of the study group and the control group after the operation have no statistically significant (P>0.05).For the study group, the average index of GLQI decreased, the difference was statistically significant at 3 months,6 months,9 months after the operation by comparing with the pre-op (P<0.05); The average GLQI of control group decreased significantly, after the operation 3 months,6 months,9 months the difference was statistically significant at were compared with that pre (P< 0.05). by analyzing all aspects such as the quality of life, subjective symptoms, physical function, daily life, social activities for the two groups, there were some index decreased significantly, the subjective symptoms of decline is more prominent, such as abdominal pain, abdominal fullness, abdominal distention decreased obviously, this is because the eating habits didn’t change after the post-op and complications. After sixth weeks of operation, the study group and the control group the GLQI was increased by comparing with 3 months after the operation, psychological, social activities are close to the level before the operation, but the subjective and the body physiological function is still negative by comparing with pre-op the difference was statistically significant (P<0.05); Ninth months after the operation, the GLQI continued to rise, the state of physiological function in patients with subjective symptoms, body continued to rise, the patient’s eating habits has been gradually adapt to the need of operation changes, the abdominal pain, abdominal bloating in patients with little discomfort; with the improvement of postoperative discomfort, and body weight decreased, the patients’ psychological mind, emotional status and social activities in this period have returned to the preoperative level. But after 9 months each index of the study group were better than the control group (P<0.05).The control group had the fat liquefaction of incision in 2 cases,1 cases with duodenal stump fistula; research group had incision fat liquefaction in 1 cases, postoperative gastrointestinal anastomotic bleeding in 1 cases. Two groups has no statistically significant of post-op complications (P>0.05).Conclusion:Laparoscopic operation for the treatment of advanced distal gastric cancer is safe and reliable, and it can obtain the same outcomes with open radical gastrectomy for gastric cancer. At the same time, the quality of life was relatively high, so it is worth learning, promotion and application. |
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