3D与2D腹腔镜远端胃癌根治术近期疗效比较研究

Comparison of the Curative Effect Between 3D and 2D Laparoscopic Radical Gastrectomy for Distal Gastric Cancer

目的:分析三维腹腔镜与二维腹腔镜下远端胃癌根治术(LARG)的手术效果及近期临床疗效。方法:应用横断面研究方法观察2017年1月至2018年1月期间在佛山市第一人民医院接受远端LARG的64例胃癌患者作为研究对象,根据入院时间的先后分为2D组和3D组,各32例。2D组患者接受传统2D腹腔镜下远端LARG,3D组接受3D腹腔镜下远端LARG。记录观察两组患者的手术时间等情况,分析临床效果。结果:3D组的平均手术时间及术中出血量均少于2D组,差异具有统计学意义(P <0.01)。3D组患者术后排气时间、术后住院时间较2D组缩短,但组间比较,差异无统计学意义(P> 0.05),64例患者均获得随访,随访1年,平均随访(7.21±1.33)个月。所有患者未出现吻合口瘘、腹腔内出血等情况,3D组并发症发生率0%,2D组并发1例,为吻合口出血,并发症发生率3%,组间比较,差异无统计学意义(P> 0.05)。结论:3D腹腔镜下远端LARG的近期手术疗效好,安全性高。

Objective To analyze the effect of 3 D laparoscopic and 2 D laparoscopic radical gastrectomy for distal gastric cancer and its clinical effects. Methods 64 patients with gastric cancer who underwent radical resection of distal gastric cancer in Foshan first people’s hospital from January 2017 to January 2018 were studied by the method of cross-sectional study, and were randomly divided into four groups, 32 cases according to the time of admission. The study subjects underwent radical resection of distal gastric cancer under the traditional 2 D laparoscopic surgery, and the group underwent a radical operation of 3 D laparoscopic gastric cancer. The surgical data of the two groups were observed, including operation time, intraoperative hemorrhage, postoperative complication. Results The mean operative time and intraoperative blood loss were lower in the 3 D group than in the 2 D group, and the difference was statistically significant(P < 0.05). The postoperative exhaust time and postoperative hospital stay in the 3 D group were shorter than those in the 2 D group, but there was no significant difference between the two groups(P > 0.05). All the 64 patients were followed up for 1 year, and the average follow-up(7.21 ± 1.33) Months. All patients had no anastomotic leakage or intra-abdominal hemorrhage. The incidence of complications was 0% in the 3 D group and 1 in the 2 D group. The anastomotic bleeding was 3 %. There was no significant difference between the two groups(P > 0.05). Conclusion The curative effect of 3 D laparoscopic radical gastrectomy for distal gastric cancer is safe and feasible.