3D腹腔镜在胃癌根治术中应用的安全性及近期疗效分析

Safety and short-term efficacy of three-dimensional laparoscopy in radical gastrectomy for gastric cancer

目的:探讨3D腹腔镜胃癌根治术的安全性及近期疗效。方法:回顾分析2020年1月至2022年12月行胃癌根治术患者的临床资料,其中42例行3D腹腔镜胃癌根治术(观察组),70例行传统2D腹腔镜胃癌根治术(对照组),比较两组患者围手术期数据。结果:两组均顺利完成手术,无中转开腹。基线资料差异无统计学意义。观察组淋巴结清扫数量多于对照组[(34.7±11.8)枚vs.(30.3±9.7)枚,P=0.033],术中出血量少于对照组[(86.3±11.0)mL vs.(98.0±20.5)mL,P=0.001],两组其余围手术期指标、并发症发生率及并发症严重程度差异无统计学意义。结论:与传统2D腹腔镜手术相比,3D腹腔镜胃癌根治术可清扫更多淋巴结,术中出血量更少,且不增加并发症风险或严重程度。3D腹腔镜胃癌根治术是安全、可行的,值得推广应用。

Objective:To assess the safety and short-term effectiveness of three-dimensional(3D)laparoscopic radical gastrectomy for gastric cancer.Methods:The clinical and pathological data of patients who underwent radical gastrectomy between Jan.2020 and Dec.2022 were retrospectively analyzed.Among the patients,42 underwent 3D laparoscopic radical gastrectomy(observation group)and 70 underwent traditional 2D laparoscopic radical gastrectomy(control group).The perioperative data of the two groups were compared.Results:Both groups successfully completed the operation without conversion to laparotomy.The baseline data did not show any significant differences between the two groups.The number of lymph nodes dissected in the observation group was more than that in the control group[(34.7±11.8)vs.(30.3±9.7),P=0.033].The observation group had significantly less intraoperative blood loss compared with the control group[(86.3±11.0)mL vs.(98.0±20.5)mL,P=0.001].There were no statistically significant diffe-rences in other perioperative indicators or the incidence and severity of complications between the two groups.Conclusions:The 3D laparoscopic radical gastrectomy for gastric cancer results in greater lymph node dissection,decreased intraoperative bleeding,and dose not increase risk of complications compared with traditional 2D laparoscopic radical gastrectomy.The use of 3D laparoscopy in the treatment of gastric cancer is safe,feasible,and should be promoted in clinical practice.