全腹腔镜远端胃癌根治术与腹腔镜辅助胃癌根治术治疗胃癌的近期疗效及安全性比较

Comparative study of short-term effect and safety between totally laparoscopic distal gastrectomy and laparoscopy assisted distal gastrectomy in the treatment of gastric cancer

目的探讨全腹腔镜远端胃癌根治术(totally laparoscopic distal gastrectomy,TLDG)与腹腔镜辅助远端胃癌根治术(laparoscopy assisted distal gastrectomy,LADG)治疗胃癌的近期疗效和安全性。方法回顾性分析2015年10月至2017年10月本院胃肠外科收治的113例原发性胃癌患者的临床资料,52例患者实施TLDG(TLDG组),同期61例患者由同组医师实施LADG(LADG组)。比较两组患者的一般资料、术中情况、术后恢复及并发症发生情况。结果 TLDG组患者手术时间、消化道吻合时间、术后下床活动时间、术后肛门排气时间、术后住院天数均显著短于LADG组(P_均<0.05),术中出血量显著少于LADG组(P<0.05),切口长度显著短于LADG组(P<0.05),术后第1天和第3天视觉模拟评分法(visual analogue scale,VAS)评分均显著低于LADG组(P_均<0.05)。两组患者术后切口感染、出血、吻合口瘘、其他与手术相关的全身并发症及气腹相关的并发症发生率比较差异均无显著性(P_均>0.05)。结论与LADG比较,TLDG具有创伤小、恢复快、住院天数短、并发症少等优势,近期效果好、安全性高。

ObjectiveTo investigate the short-term effect between totally laparoscopic distal gastrectomy （TLDG） and laparoscopy assisted distal gastrectomy （LADG） in the treatment of gastric cancer. MethodClinical data of 113 patients with primary gastric cancer from October 2015 to October 2017 in our hospital were analyzed, 52 cases of patients treated with TLDG （TLDG group）, 61 cases of patients treated with LADG （LADG group） during the same time by the doctors of the same group. The general data, intraoperative conditions, postoperative recovery and postoperative complications were compared between the two groups. ResultThe operation time, gastrointestinal anastomosis time, postoperative out-of-bed activity time, postoperative anal exhaust time, postoperative hospital days in TLDG group were signi？cantly shorter than those in LADG group （Pall〈 0.05）, the intraoperative blood loss was less than that in LADG group （P 〈 0.05）, incision length was shorter than that in LADG group （P 〈 0.05）, visual analogue scale （VAS） scores on the first day and third day after operation were significantly lower than those in LADG group （Pall〈 0.05）. There were no signi？cant di？erences in incision infection, hemorrhage, anastomotic stoma ？stula and other surgical related systemic complications and pneumoperitoneum related complications between the two groups （Pall〉 0.05）. ConclusionCompared with LADG, TLDG has advantages such as less trauma, quicker recovery, shorter hospitalization time and fewer complications, and has good short-term e？ect and high safety.