全腔镜与腹腔镜辅助远端胃癌根治术的疗效比较*

Comparison of curative effect between totally laparoscopic and laparoscopically assisted distal gastrectomy*

摘要:

摘要：目的??探讨全腔镜远端胃癌根治术（TLDG）与腹腔镜辅助远端胃癌根治术（LADG）在消化道重建中的安全性、可行性及临床疗效。方法 回顾性分析2014年1月－2015年12月在该院治疗的患者174例，分为TLDG组84例和LADG组90例，所有患者均接受同一组医师手术，对比两组患者手术时间、切口长度、术中出血量、肿瘤大小、淋巴结个数、术后排气时间、进食流质时间、止痛药使用时间、住院时间、住院费用、术后出血、吻合口瘘、吻合口狭窄、感染及其他并发症，同时比较两组患者的短期预后情况。结果 174例患者手术均顺利完成，无中转开腹，无死亡病例。两组患者术中出血量、肿瘤大小、淋巴结清扫数、术后出血、吻合口瘘、吻合口狭窄、感染及其他并发症比较，差异均无统计学意义（P?>?0.05）；TLDG组手术时间、切口长度、术后排气时间、进食流质时间、止痛药使用时间及住院时间较LADG组短，住院总费用较LADG组高，差异均有统计学意义（P??0.05）。结论 TLDG是安全可行的，并有较好的短期疗效。

Abstract:

Abstract: Objective?To explore the safety, feasibility and clinical efficacy of total laparoscopic distal gastrectomy (TLDG) and laparoscopically assisted distal gastrectomy (LADG) in digestive tract reconstruction.?Methods?A retrospective analysis of 84 patients (TLDG group) and 90 patients (LADG group) from January 2014 to December 2015. All the patients underwent operation by the same group of surgeons. The operation time, incision length and intraoperative bleeding volume were compared between the two groups. The short-term prognosis of the two groups was compared. The size of tumors, the number of lymph nodes, the time of exhaust after operation, the time of taking fluids, the time of using painkillers, the time of hospitalization, the cost of hospitalization, the bleeding after operation, anastomotic fistula, anastomotic stenosis, infection and other complications were also compared.?Results?174 patients were successfully operated without conversion to laparotomy or death. There were no significant differences in blood loss, tumor size, lymph node dissection, postoperative bleeding, anastomotic fistula, anastomotic stenosis, infection and other complications between the two groups (P?>?0.05). In TLDG group, the operation time, incision length, postoperative exhaust time, feeding fluids time, use time of analgesics and residence time were not significant (P?>?0.05). Hospitalization time was shorter than LADG group, total hospitalization cost was higher than LADG group, the difference was statistically significant (P??0.05).?Conclusion?TLDG is safe and feasible, and has a good short-term effect.