腹腔镜下不同入路胰腺上方胃系膜切除术治疗进展期胃癌患者的效果比较

Comparison of the Effects of Laparoscopic Suprapancreatic Mesogastrectomy with Different Approaches in the Treatment of Advanced Gastric Cancer Patients

目的:探讨腹腔镜下不同入路胰腺上方胃系膜切除胃癌根治术治疗进展期胃癌患者的效果.方法:选取2020年9月至2022年9月于本院接受腹腔镜下胰腺上方胃系膜切除术治疗的96例进展期胃癌患者为研究对象.按随机数字表法,将其分为右侧入路组(n=48,实施腹腔镜下右侧入路胰腺上方胃系膜切除术)和左侧入路组(n=48,实施腹腔镜下左侧入路胰腺上方胃系膜切除术).比较两组患者手术情况、术后恢复情况及术后并发症发生情况.结果:右侧入路组患者术中出血量少于左侧入路组,淋巴结清扫数量多于左侧入路组,手术时间短于左侧入路组,差异均有统计学意义(P<0.05);两组患者下床活动时间、首次排气时间、住院时间以及术后并发症总发生率比较,差异均无统计学意义(P>0.05).结论:腹腔镜下右侧入路和左侧入路胰腺上方胃系膜切除术治疗进展期胃癌患者均安全有效,但右侧入路在降低术中出血量、增加淋巴结清扫数量及减少手术时间方面更具优势.

Objective:To explore the effects of laparoscopic suprapancreatic mesogastrectomy with different approaches for the treatment of advanced gastric cancer patients.Methods:A total of 96 patients with advanced gastric cancer who underwent laparoscopic suprapancreatic gastrectomy in our hospital from September 2020 to September 2022 were selected as the study subjects.They were randomly divided into right approach group(n=48,received laparoscopic suprapancreatic mesogastrectomy with right approaches)and left approach group(n=48,received laparoscopic suprapancreatic mesogastrectomy with left approaches).The surgical outcomes,postoperative recovery,and incidence of postoperative complications were compared between the two groups.Results:The right approach group had less intraoperative bleeding,more lymph node dissection,and shorter surgical time compared to left approach group,and the differences were statistically significant(P<0.05).There was no significant difference between the two groups in terms of time spent getting out of bed,first exhaust time,hospitalization time,and incidence of postoperative complications(P>0.05).Conclusion:Laparoscopic right approach and left approach suprapancreatic mesogastrectomy are both safe and effective for the treatment of advanced gastric cancer patients,but the right approach has advantages in reducing intraoperative bleeding,increasing lymph node dissection,and reducing surgical time.