全腹腔镜与辅助腹腔镜下远端胃癌根治术的近期疗效和安全性研究

Short-term Efficacy and Safety of Total Laparoscopic and Laparoscopic-assisted Radical Gastrectomy on Distal Gastric Cancer

目的探讨全腹腔镜与辅助腹腔镜下远端胃癌根治术的近期疗效及安全性。方法回顾性分析福建医科大学附属第一医院胃肠外科二区2016年2月—2017年8月收治的行腹腔镜远端胃癌根治术患者80例,根据手术方式分为全腹腔镜组(45例)和辅助腹腔镜组(35例),比较两组患者的手术相关指标。结果在术中指标方面,两组患者的手术时长和淋巴结清扫总数比较,差异均无统计学意义(均P>0.05),但全腹腔镜组的切口长度和术中出血量均短于(少于)辅助腹腔镜组,差异具有统计学意义(均P<0.05);在术后恢复指标方面,两组患者的术后排气时间、术后住院天数及术后总并发症比较,差异无统计学意义(均P>0.05)。结论全腹腔镜下远端胃癌根治术具有术中出血少、手术切口长度较短、对机体损伤轻、愈合的瘢痕小等优点易于被患者所接受。因此,全腹腔镜下远端胃癌根治术疗效更好且安全可行。

Objective To explore the short-term efficacy and safety of total laparoscopic gastrectomy and laparoscopic-assisted radical gastrectomy in the treatment of distal gastric cancer.Methods A total of 80 patients with distal gastric cancer in the First Affiliated Hospital of Fujian Medical University from February 2016 to August 2017 were divided into two groups:45 patients were treated with total laparoscopic gastrectomy,and 35 patients were treated with laparoscopic-assisted gastrectomy.The short-term curative effect and safety of two groups were compared.Results In the aspect of intra-operative indicators,the operation time and the number of removed lymph node between two groups did not differed to each other(P>0.05),while the length of incision and the bleeding volume in total laparoscopy group were significantly smaller than those in the laparoscopy-assisted group(P<0.05).In the aspect of post-operative indicators,the time to first flatus,hospital stay and the total incidence of complications between two groups did not significantly differed to each other(P>0.05).Conclusion Comparing with the laparoscopic-assisted gastrectomy,total laparoscopic gastrectomy is safe and feasible with the advantage of less bleeding volume,shorter incision length and smaller healing scar,which are helpful for the patients to accept it.