目的:对比腹腔镜远端胃切除术(LDG)与保留幽门胃切除术(LPPG)治疗早期胃癌的有效性与安全性。方法:选取2018年3月至2022年3月收治的108例早期胃癌患者,根据手术方式分为两组,68例行LDG(LDG组),40例行LPPG(LPPG组),对比分析两组手术情况...目的:对比腹腔镜远端胃切除术(LDG)与保留幽门胃切除术(LPPG)治疗早期胃癌的有效性与安全性。方法:选取2018年3月至2022年3月收治的108例早期胃癌患者,根据手术方式分为两组,68例行LDG(LDG组),40例行LPPG(LPPG组),对比分析两组手术情况、术后恢复情况、术后并发症发生率、住院费用等。结果:两组手术时间、术中出血量、淋巴结清扫数量、术后恢复相关指标(首次排气、排便、进食、引流管拔除、胃管拔除、住院时间)差异无统计学意义(P>0.05)。与LDG组相比,LPPG组肿瘤远切缘短,住院总费用低,胃排空延迟发生率高(30.00%vs.7.35%),反酸发生率低(0 vs. 20.59%),差异有统计学意义(P<0.05)。LDG组与LPPG组术后并发症总发生率差异无统计学意义(32.35%vs. 35.00%,P>0.05)。术后1年,LPPG组继发性胆汁反流性胃炎的发生率低于LDG组,Ⅱ~Ⅲ度胆汁反流性胃炎发生率亦低于LDG组(P<0.05)。LDG组与LPPG组3年生存率差异无统计学意义(80.88%vs. 80.00%,P>0.05)。结论:LPPG与LDG治疗早期胃癌均具有较好效果,LPPG更有助于减少术后反酸及继发性胆汁反流性胃炎的发生,治疗费用更低。展开更多
背景:探讨腹腔镜全胃切除术中应用手工吻合和管型吻合的手术疗效及其对预后的影响。方法:我们回顾性分析了安徽医科大学第二附属医院胃肠外科2021年10月至2023年10月间收治的112例行腹腔镜全胃切除术胃癌患者的临床病理资料,并将其分为...背景:探讨腹腔镜全胃切除术中应用手工吻合和管型吻合的手术疗效及其对预后的影响。方法:我们回顾性分析了安徽医科大学第二附属医院胃肠外科2021年10月至2023年10月间收治的112例行腹腔镜全胃切除术胃癌患者的临床病理资料,并将其分为手工吻合组(H组,N = 60)和管型吻合组(C组,N = 52),比较腹腔镜全胃切除术中应用手工吻合与管型吻合的手术疗效和预后情况。结果:两组在术中出血量、首次排气时间、术后住院时间、术后并发症等方面的差异均无统计学意义(P > 0.05)。H组的食管空肠吻合时间(20.40 ± 1.83 vs 34.71 ± 1.80)及手术时间更短(252.60 ± 21.91 vs 267.40 ± 19.42)、切口更小(5.07 ± 0.65 vs 10.47 ± 0.87)、住院费用更低(59496.04 ± 5555.51元 vs 64656.13 ± 4340.65元) (P Objective: To investigate the surgical efficacy of applying manual and tubular anastomoses in laparoscopic total gastrectomy and its impact on prognosis. Methods: Retrospective analysis is adopted to the clinicopathologic data of 112 patients with gastric cancer (GC) who went through LTG in the Department of General Surgery, the Second Affiliated Hospital of Anhui Medical University between October 2020 and October 2022. Among them, 60 individuals receiving medical care were split into the hand-sewn anastomosis group (Group H, N = 60);while, 52 individuals were split into the circular stapler anastomosis group (Group C, N = 52) The clinical efficacy and prognostic conditions of hand-sewn anastomosis are compared with those of circular stapler anastomosis in the application of LTG. Results: The analysis results indicated that no notable difference was observed in intraoperative bleeding volume, time to first flatus (TFF), postoperative hospitalization duration and postoperative complications among the two groups (P > 0.05). Group H had shorter esophagojejunal anastomosis time (20.40 ± 1.83 vs 34.71 ± 1.80) and operative time (252.60 ± 21.91 vs 267.40 ± 19.42), smaller incision (5.07 ± 0.65 vs 10.47 ± 0.87), and lower hospitalisation cost (59496.04 ± 5555.51 yuan vs 64656.13 ± 4340.65 yuan) (P < 0.05). Conclusion: The clinical efficacy and the postoperative complications of hand-sewn esophagojejunostomy are basically equivalent in comparison to the circular stapler anastomosis in the application of LTG. Its advantage lies in shorter esophagojejunal anastomosis duration, shorter surgery duration, smaller incisions, lower hospitalization costs and wider adaptability of the location of the tumor.展开更多
文摘目的:对比腹腔镜远端胃切除术(LDG)与保留幽门胃切除术(LPPG)治疗早期胃癌的有效性与安全性。方法:选取2018年3月至2022年3月收治的108例早期胃癌患者,根据手术方式分为两组,68例行LDG(LDG组),40例行LPPG(LPPG组),对比分析两组手术情况、术后恢复情况、术后并发症发生率、住院费用等。结果:两组手术时间、术中出血量、淋巴结清扫数量、术后恢复相关指标(首次排气、排便、进食、引流管拔除、胃管拔除、住院时间)差异无统计学意义(P>0.05)。与LDG组相比,LPPG组肿瘤远切缘短,住院总费用低,胃排空延迟发生率高(30.00%vs.7.35%),反酸发生率低(0 vs. 20.59%),差异有统计学意义(P<0.05)。LDG组与LPPG组术后并发症总发生率差异无统计学意义(32.35%vs. 35.00%,P>0.05)。术后1年,LPPG组继发性胆汁反流性胃炎的发生率低于LDG组,Ⅱ~Ⅲ度胆汁反流性胃炎发生率亦低于LDG组(P<0.05)。LDG组与LPPG组3年生存率差异无统计学意义(80.88%vs. 80.00%,P>0.05)。结论:LPPG与LDG治疗早期胃癌均具有较好效果,LPPG更有助于减少术后反酸及继发性胆汁反流性胃炎的发生,治疗费用更低。
文摘背景:探讨腹腔镜全胃切除术中应用手工吻合和管型吻合的手术疗效及其对预后的影响。方法:我们回顾性分析了安徽医科大学第二附属医院胃肠外科2021年10月至2023年10月间收治的112例行腹腔镜全胃切除术胃癌患者的临床病理资料,并将其分为手工吻合组(H组,N = 60)和管型吻合组(C组,N = 52),比较腹腔镜全胃切除术中应用手工吻合与管型吻合的手术疗效和预后情况。结果:两组在术中出血量、首次排气时间、术后住院时间、术后并发症等方面的差异均无统计学意义(P > 0.05)。H组的食管空肠吻合时间(20.40 ± 1.83 vs 34.71 ± 1.80)及手术时间更短(252.60 ± 21.91 vs 267.40 ± 19.42)、切口更小(5.07 ± 0.65 vs 10.47 ± 0.87)、住院费用更低(59496.04 ± 5555.51元 vs 64656.13 ± 4340.65元) (P Objective: To investigate the surgical efficacy of applying manual and tubular anastomoses in laparoscopic total gastrectomy and its impact on prognosis. Methods: Retrospective analysis is adopted to the clinicopathologic data of 112 patients with gastric cancer (GC) who went through LTG in the Department of General Surgery, the Second Affiliated Hospital of Anhui Medical University between October 2020 and October 2022. Among them, 60 individuals receiving medical care were split into the hand-sewn anastomosis group (Group H, N = 60);while, 52 individuals were split into the circular stapler anastomosis group (Group C, N = 52) The clinical efficacy and prognostic conditions of hand-sewn anastomosis are compared with those of circular stapler anastomosis in the application of LTG. Results: The analysis results indicated that no notable difference was observed in intraoperative bleeding volume, time to first flatus (TFF), postoperative hospitalization duration and postoperative complications among the two groups (P > 0.05). Group H had shorter esophagojejunal anastomosis time (20.40 ± 1.83 vs 34.71 ± 1.80) and operative time (252.60 ± 21.91 vs 267.40 ± 19.42), smaller incision (5.07 ± 0.65 vs 10.47 ± 0.87), and lower hospitalisation cost (59496.04 ± 5555.51 yuan vs 64656.13 ± 4340.65 yuan) (P < 0.05). Conclusion: The clinical efficacy and the postoperative complications of hand-sewn esophagojejunostomy are basically equivalent in comparison to the circular stapler anastomosis in the application of LTG. Its advantage lies in shorter esophagojejunal anastomosis duration, shorter surgery duration, smaller incisions, lower hospitalization costs and wider adaptability of the location of the tumor.
