Zhang Bo, Tu Jian-Cheng, Fang Jian, Zhou Liang, Liu Ye-Lu
Department of General Surgery, Zhangjiagang Hospital Affiliated to Soochow University Zhangjiagang 215600, Jiangsu Province, P. R. China.
Department of General Surgery, Huai'an First People's Hospital, Nanjing Medical University Huai'an 223300, Jiangsu Province, P. R. China.
Int J Clin Exp Med. 2015 Jun 15;8(6):9967-72. eCollection 2015.
To compare early-term effects of totally laparoscopic distal gastrectomy with delta-shaped anastomosis (D-STLDG) with conventional laparoscopic-assisted distal gastrectomy (LADG).
Clinical data of 24 patients who received D-STLDG from April 2013 to April 2014, and 45 patients who received LADG from March 2010 to December 2012 were retrospectively analyzed. The operative time, intra-operative blood loss, post-operative recovery time of intestinal function, post-operative pain, the length of post-operative hospital stay and the incidence of post-operative complications (infection, obstruction and delayed gastric emptying) were compared between the two groups.
All procedures were completed successfully and all patients of both groups were discharged smoothly from hospital. Compared with LADG, D-STLDG had shorter operative time (175.3±64.7 min vs. 205.8±42.2 min, P<0.05), less intra-operative blood (50.8±25.3 ml vs. 75.2±22.5 ml, P<0.05), shorter post-operative recovery time of intestinal function (1.2±0.5 d vs. 2.1±0.8 d, P<0.05), less post-operative pain (5.6±0.7 vs. 7.8±0.5, P<0.05), shorter post-operative hospital stay (8.5±2.2 d vs. 10.5±3.5 d, P<0.05). There were no significant difference in surgical margins achieved, the number of lymph nodes retrieved or the incidence of post-operative complications (infection, obstruction and delayed gastric emptying) (P>0.05).
The delta-shaped anastomosis of reconstructing the digestive tract in TLDG appears to be safe, feasible and associated to faster recovery.
比较全腹腔镜下三角吻合远端胃切除术(D-STLDG)与传统腹腔镜辅助远端胃切除术(LADG)的早期效果。
回顾性分析2013年4月至2014年4月接受D-STLDG的24例患者以及2010年3月至2012年12月接受LADG的45例患者的临床资料。比较两组患者的手术时间、术中出血量、术后肠功能恢复时间、术后疼痛程度、术后住院时间以及术后并发症(感染、梗阻和胃排空延迟)的发生率。
所有手术均顺利完成,两组患者均顺利出院。与LADG相比,D-STLDG的手术时间更短(175.3±64.7分钟 vs. 205.8±42.2分钟,P<0.05),术中出血量更少(50.8±25.3毫升 vs. 75.2±22.5毫升,P<0.05),术后肠功能恢复时间更短(1.2±0.5天 vs. 2.1±0.8天,P<0.05),术后疼痛程度更轻(5.6±0.7 vs. 7.8±0.5,P<0.05),术后住院时间更短(8.5±2.2天 vs. 10.5±3.5天,P<0.05)。两组在切缘、清扫淋巴结数量或术后并发症(感染、梗阻和胃排空延迟)的发生率方面无显著差异(P>0.05)。
全腹腔镜下远端胃切除术中采用三角吻合重建消化道似乎是安全、可行的,且能促进更快恢复。