改良腹腔镜-内镜双镜联合手术与腹腔镜辅助内镜下切除术治疗早期胃癌的临床效果分析

Clinical effect analysis of modified laparoscopic endoscopic cooperative surgery and laparoscopic assisted endoscopic resection for early gastric cancer

目的探讨改良腹腔镜-内镜双镜联合手术(MLECS)与腹腔镜辅助内镜下切除术(LAER)治疗早期胃癌的临床效果。方法前瞻性选取2018年1月至2020年6月期间收治的94例早期胃癌患者作为研究对象,采用数字随机法将患者分为LAER组和MLECS组,每组47例。LAER组采用腹腔镜辅助内镜下切除术治疗,MLECS组采用改良腹腔镜-内镜双镜联合手术治疗。选用SPSS 22.0软件处理数据,围手术期各项指标和视觉模拟量表(VAS)疼痛评分等计量资料以(x±s)表示,行独立样本t检验;术后并发症等计数资料以[n(%)]表示,行X^(2)检验。P<0.05表示差异有统计学意义。结果MLECS组患者的手术时间、术中出血量、术后排气时间及VAS评分明显低于LAER组(P<0.05);两组患者术后住院时间比较差异无统计学意义(P>0.05);两组患者术后总并发症的发生率比较(6.4% vs 12.8%),差异无统计学意义(P>0.05);术后随访6~36个月,中位随访时间21个月,两组患者均未出现复发和转移。结论MLECS手术治疗早期胃癌安全、有效、可行,具有手术时间短、创伤小、恢复快等优势,更能体现微创外科的优越性。

Objective To investigate the clinical effect of modified laparoscopic endoscopic cooperative surgery(MLECS)and laparoscopic assisted endoscopic resection(LAER)in the treatment of early gastric cancer.Methods The clinical data of 94 patients with early gastric cancer from January 2018 to June 2020 were randomly divided into LAER group and MLECS group,with 47 patients in each group.The LAER group was treated with laparoscopic assisted endoscopic resection,and the MLECS group was treated with modified laparoscopic and endoscopic cooperative surgery.SPSS 22.0 software was used for data processing.Perioperative indicators,visual analog scale(VAS)pain score and other measurement data were represented by(x±s),and independent t test was performed.Postoperative complications were expressed by[n(%)]and,X^(2) test was performed.P<O.05 indicated statistically significant difference.Results The operation time,intraoperative blood loss,postoperative exhaust time and VAS score in MLECS group were significantly lower than those in LAER group(P<O.05).There was no significant difference in postoperative hospital stay between 2 groups(P>O.05);There was no significant difference in the incidence of postoperative complications between the two groups(6.4%vs.12.8%,P>O.05);Postoperative follow-up was 6-36 months,with a median follow-up of 21 months.No recurrence or metastasis occurred in both groups.Conclusion MLECS surgery is safe,effective and feasible for the treatment of early gastric cancer.It has the advantages of short operation time,small trauma and quick recovery,which fully reflects the advantages of minimally invasive surgery.