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  

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[1] 朱泓宇 周健[1] 宋辉[1] 杨军[1] 宋庆杰 NI Li-xin;ZHU Hong-yu;ZHOU Jian(Department of the Second General Surgery,Qidong People’s Hospital,Nantong 226200,China)

机构地区：[1]启东市人民医院,江苏南通226200

出　　处：《腹腔镜外科杂志》2019年第1期25-29,共5页Journal of Laparoscopic Surgery

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)mL vs.(52.0±11.5)mL,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.

关 键 词：胃肿瘤 胃癌根治术 腹腔镜检查 疗效比较研究 

分 类 号：R735.2[医药卫生—肿瘤]