全腹腔镜与腹腔镜辅助远端胃癌根治术的近期疗效对比分析

Comparative Analysis of Short Term Effect of Total Laparoscopic and Laparoscopic Assisted Radical Gastrectomy for Distal Gastric Cancer

目的:比较全腹腔镜与腹腔镜辅助远端胃癌根治术治疗胃癌的近期治疗效果。方法:回顾性分析本院2015年4月-2016年3月收治的行腹腔镜远端胃癌根治术患者48例,所有患者均由同组医生手术,将其分为全腹腔镜组18例和腹腔镜辅助组30例,比较两组患者的手术时间、淋巴结清扫数目、术中出血量、切口长度、术后排气时间、疼痛评分、住院时间及并发症。结果:全腹腔镜组手术时间明显长于腹腔镜辅助组,比较差异有统计学意义(P<0.05);全腹腔镜组术中出血量、切口长度及术后疼痛评分均低于腹腔镜辅助组,比较差异均有统计学意义(P<0.05);两组淋巴结清扫数目、术后排气时间、术后住院时间及术后并发症比较,差异均无统计学意义(P>0.05)。结论:全腹腔镜具有术中出血量少、术后疼痛评分低等优点,有助于患者术后的早期恢复,而且由于术中切口长度小,美容效果更好,患者更容易接受。因此,全腹腔镜远端胃癌根治术值得临床推广和应用。

Objective：To compare the short-term therapeutic effect of total laparoscopic and laparoscopic assisted distal gastrectomy in the treatment of distal gastric cancer.Method：From April 2015 to March 2016, 48 cases of laparoscopic distal gastrectomy for gastric cancer in our hospital were retrospective analyzed,all patients were operated by the same group of doctors,they were divided into the 18 cases of the total laparoscopic group and 30 cases of laparoscopic assisted group,the operation time,number of lymph node dissection, intraoperative blood loss,incision length,postoperative exhaust time,pain score,length of stay and complications of two groups were compared.Result：The operation time of total laparoscopic group was longer than that of the laparoscopic assisted group,the difference was statistically significant（P〈0.05）.The intraoperative blood loss,incision length and pain score in the total laparoscopic group were lower than those of the laparoscopic assisted group,the differences were statistically significant（P〈0.05）.There were no statistically differences in the number of lymph node dissection,postoperative exhaust time,length of stay and complications of two groups （P〉0.05）.Conclusion：Total laparoscopic surgery has the advantages of less blood loss,early postoperative exhaust time and low postoperative pain score,which is helpful for the early postoperative recovery of patients, and because the incision length is small,the cosmetic effect is better,the patient is more easy to accept.Therefore, total laparoscopic distal gastrectomy is worthy of clinical popularization and application.