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[腹腔镜辅助与全腹腔镜远端胃癌切除术短期疗效比较]

[Comparison of short-term outcomes of laparoscopy-assisted and totally laparoscopic distal gastrectomy for gastric cancer].

作者信息

Ma F H, Li Y, Li W K, Kang W Z, Chen Y T, Xie Y B, Yin Z H, Zhang Y, Tian Y T

机构信息

Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

Department of General Surgery, the Seventh People's Hospital of Baoding, Baoding 072150, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2019 Mar 23;41(3):229-234. doi: 10.3760/cma.j.issn.0253-3766.2019.03.014.

Abstract

To assess the safety, feasibility and short-term outcome of totally laparoscopic distal gastrectomy(TLDG). Seventy-five patients who underwent laparoscopic distal gastrectomy in Cancer Hospital of Chinese Academy of Medical Science between August 2015 and April 2018 were enrolled in this study. A total of 46 laparoscopy-assisted distal gastrectomy (LADG) cases and 29 TLDG cases were included. The Short-term outcomes and safeties of the two groups were compared. The operation time of TLDG group was significantly longer than that of LADG group (207±41 vs. 156±34 min, <0.001), while the length of wound was shorter in the TLDG group (3.6±0.6 vs. 5.8±0.8 cm, <0.001). The time to first flatus in TLDG group was (3.3±0.6) days, significantly shorter than (3.7±0.8) days in LADG group (=0.034). There were no significant differences between the two groups in the estimated blood loss, intraoperative blood transfusion, extraction of gastric tube, drainage tube removal, interval of the first time to eat semi-liquid food, postoperative hospital stays, surgical complications, number of retrieved lymph nodes, proximal and distal resection margin lengths (all >0.05). The white blood cell count at postoperative day 1 in the TLDG group was (10.96±1.96) ×10(9)/L, significantly lower than (12.49±3.46)×10(9)/L of the LADG group (=0.017). While the CRP level at postoperative day 1 in the TLDG group were lower than that of LADG group, no statistical difference was observed (=0.072). Our study shows that TLDG is safe and feasible. TLDG has better cosmesis, less blood loss, and faster recovery compared to LADG.

摘要

评估完全腹腔镜下远端胃癌切除术(TLDG)的安全性、可行性及短期疗效。选取2015年8月至2018年4月在中国医学科学院肿瘤医院接受腹腔镜远端胃癌切除术的75例患者纳入本研究。共纳入46例腹腔镜辅助远端胃癌切除术(LADG)病例和29例TLDG病例。比较两组的短期疗效和安全性。TLDG组的手术时间显著长于LADG组(207±41 vs. 156±34分钟,<0.001),而TLDG组的切口长度较短(3.6±0.6 vs. 5.8±0.8厘米,<0.001)。TLDG组首次排气时间为(3.3±0.6)天,显著短于LADG组的(3.7±0.8)天(=0.034)。两组在估计失血量、术中输血、拔除胃管、拔除引流管、首次进食半流质食物的时间间隔、术后住院时间、手术并发症、获取的淋巴结数量、近端和远端切缘长度方面均无显著差异(均>0.05)。TLDG组术后第1天的白细胞计数为(10.96±1.96)×10⁹/L,显著低于LADG组的(12.49±3.46)×10⁹/L(=0.017)。虽然TLDG组术后第1天的CRP水平低于LADG组,但未观察到统计学差异(=0.072)。我们的研究表明,TLDG是安全可行的。与LADG相比,TLDG具有更好的美容效果、更少的失血量和更快的恢复速度。

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