完全腹腔镜与腹腔镜辅助远端胃癌根治术的近期临床疗效对比研究

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英文篇名：A comparative study of clinical short-term efficacy between total laparoscopic gastrectomy and laparoscopy-assisted gastrectomy for distal gastric cancer 作者：倪立新 ; 朱泓宇 ; 周健 ; 宋辉 ; 杨军 ; 宋庆杰 英文作者：NI Li-xin;ZHU Hong-yu;ZHOU Jian;Department of the Second General Surgery,Qidong People's Hospital; 关键词：胃肿瘤 ; 胃癌根治术 ; 腹腔镜检查 ; 疗效比较研究 英文关键词：Stomach neoplasms;;Radical gastrectomy for gastric cancer;;Laparoscopy;;Comparative effectiveness research 中文刊名：FQJW 英文刊名：Journal of Laparoscopic Surgery 机构：启东市人民医院; 出版日期：2019-01-20 出版单位：腹腔镜外科杂志 年：2019 期：v.24 语种：中文; 页：FQJW201901005 页数：5 CN：01 ISSN：37-1361/R 分类号：31-35

摘要

目的:对比完全腹腔镜与腹腔镜辅助远端胃癌根治术的短期临床疗效,探讨完全腹腔镜下远端胃癌根治术的安全性及可推广性。方法:回顾分析2016年1月至2018年7月施行完全腹腔镜远端胃癌根治术(完全组,n=36)与腹腔镜辅助下远端胃癌根治术(辅助组,n=42)的临床资料。结果:完全组胃肠吻合时间[(24.2±11.5) min vs.(26.1±10.3) min,t=-4.719,P=0.684]、术中出血量[(42.0±9.5) m L vs.(52.0±11.5) m L,t=-0.792,P=0.416]与辅助组相比差异无统计学意义,但切口长度[(3.0±2.0) cm vs.(6.5±2.5) cm,t=-19.134,P<0.001]、肛门排气时间[(2.0±0.7) d vs.(3.0±0.8) d,t=-8.177,P=0.001]、进食流质时间[(2.5±1.0) d vs.(3.2±0.8) d,t=-8.792,P<0.001]、住院时间[(9.1±1.2) d vs.(11.9±1.5) d,t=-11.921,P<0.001]优于辅助组,且术后患者需要止痛剂剂量[(2.5±1.0)支vs.(4.0±1.2)支,t=-13.713,P<0.001]少。完全组出现吻合口漏1例,辅助组均未发生吻合口相关并发症。结论:完全腹腔镜远端胃癌根治术安全、可行,具有创伤小、康复快、住院时间短、疼痛轻等优势,近期疗效显著。
        Objective: To compare the clinical short-term efficacy between total laparoscopic and laparoscopic-assisted distal gastrectomy for gastric cancer and to explore the safety and replicability of total laparoscopic distal gastrectomy.Methods: The clinical data of 36 patients who received total laparoscopic distal gastrectomy and 42 patients who underwent laparoscopic-assisted distal gastrectomy from Jan.2016 to Jul.2018 were retrospectively analyzed.Results: Compared with the laparoscopic-assisted group,the gastrointestinal anastomosis time [( 24.2±11.5) min vs.( 26.1±10.3) min,t =-4.719,P = 0.684]and intraoperative blood loss [( 42.0±9.5) m L vs.( 52.0±11.5) m L,t=-0.792,P= 0.416]of the total laparoscopic group were not statistically significantly different,but the length of the incision [( 3.0±2.0) cm vs.( 6.5±2.5) cm,t =-19.134,P<0.001],the anal exhaust time [( 2.0±0.7) d vs.( 3.0±0.8) d,t =-8.177,P =0.001],the fluid intake time [( 2.5±1.0) d vs.( 3.2±0.8) d,t =-8.792,P<0.001] and hospitalization time [( 9.1± 1.2) d vs.( 11.9±1.5) d,t =-11.921,P<0.001] were significantly shorter.Besides,the postoperative analgesic dosage in total laparoscopic group [( 2.5±1.0) vs.( 4.0±1.2),t =-13.713,P<0.001] was reduced.There was 1 case of anastomotic leakage in the total laparoscopic group,while no anastomotic-related complications occurred in the laparoscopic-assisted group.Conclusions: Total laparoscopic distal gastrectomy is safe and feasible.It has the advantages of few trauma,quick recovery,short hospital stay and mild pain,the short-term efficacy is remarkable.

引文

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