Department of Surgery, JA Sapporo Kosei Hospital, N3, E8, Chuo-ku, Sapporo, 060-0033, Japan.
Surg Endosc. 2010 Nov;24(11):2739-42. doi: 10.1007/s00464-010-1037-7. Epub 2010 Apr 3.
Laparoscopic gastrectomy (LAG) is recognized as a less invasive surgery, but no advantage in terms of respiratory function recovery has been demonstrated. We investigated respiratory function recovery in the early period after LAG compared with open gastrectomy (OG) for measuring the recovery of oxygen saturation level (SaO(2)).
The study population comprised 454 patients who underwent distal gastrectomy or total gastrectomy for preoperatively diagnosed T1N0 gastric cancer: 192 underwent laparoscopy-assisted distal gastrectomy (LADG), 190 underwent open distal gastrectomy (ODG), 42 underwent laparoscopy-assisted total gastrectomy (LATG), and 30 underwent open total gastrectomy (OTG).
The number of days until SaO(2) reached 95% or higher in room air was significantly smaller in the LADG group (1.54 days) than in the ODG group (1.81 days; p = 0.010) and also significantly smaller in the LATG group (1.48 days) than in the OTG group (2.03 days; p = 0.043).
LAG patients recovered their oxygenation earlier than OG patients. The laparoscopic procedure might confer a respiratory benefit for gastrectomy patients.
腹腔镜胃切除术(LAG)被认为是一种创伤较小的手术,但在呼吸功能恢复方面没有优势。我们研究了 LAG 与开腹胃切除术(OG)相比在早期的呼吸功能恢复情况,以测量氧饱和度水平(SaO2)的恢复情况。
研究人群包括 454 例因术前诊断为 T1N0 胃癌而行远端胃切除术或全胃切除术的患者:192 例行腹腔镜辅助远端胃切除术(LADG),190 例行开腹远端胃切除术(ODG),42 例行腹腔镜辅助全胃切除术(LATG),30 例行开腹全胃切除术(OTG)。
SaO2 达到 95%或更高的天数在 LADG 组(1.54 天)明显少于 ODG 组(1.81 天;p=0.010),在 LATG 组(1.48 天)也明显少于 OTG 组(2.03 天;p=0.043)。
LAG 患者的氧合恢复早于 OG 患者。腹腔镜手术可能为胃切除术患者带来呼吸益处。