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双端口腹腔镜远端胃癌根治术的初步经验:单臂研究。

Initial Experience of Dual-Port Laparoscopic Distal Gastrectomy for Gastric Cancer: A Single-Arm Study.

机构信息

Department of General Surgery, Nanfang Hospital of Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China.

出版信息

Adv Ther. 2019 Sep;36(9):2342-2350. doi: 10.1007/s12325-019-01029-x. Epub 2019 Jul 23.

Abstract

INTRODUCTION

Dual-port laparoscopic gastrectomy (DPLG) has been widely performed in recent years for treating gastric cancers. The present study reports our initial experience of dual-port laparoscopic distal gastrectomy (DPLDG).

METHODS

From November 2016 to August 2018, 38 consecutive patients underwent DPLDG in our center. The observational outcomes included 30-day morbidity and mortality rates, time to first flatus, time to first oral liquid diet, time to first oral semiliquid diet, time to drainage tube removal, visual analogue scale (VAS) score, postoperative 4-day recovery rate, additional analgesic use, hospital stay and cosmetic benefits.

RESULTS

Mean operative time was 191.6 ± 44.4 min, mean intra-operative blood loss was 39.8 ± 48.7 ml, and the mean number of dissected lymph nodes was 38.3 ± 13.7 nodes. One case was converted to five-port laparoscopic surgery, and no intraoperative complications occurred in any of the cases. The mean time to postoperative first flatus was 45.3 ± 18.0 h. The mean time to intake of an oral liquid diet was 56.7 ± 30.4 h. The mean time to drainage tube removal was 97.9 ± 52.3 h. The mean VAS scores for the 3 days after surgery were 2.3 ± 0.7, 2.0 ± 0.6 and 1.6 ± 0.5, respectively. A total of 81.6% of the enrolled patients met the postoperative 4-day recovery standard, and 15.8% of patients received additional analgesics. The mean postoperative hospital stay was 6.0 ± 2.0 days. No deaths were observed, and the 30-day morbidity rate was 13.2%.

CONCLUSION

DPLDG is a feasible and safe procedure for experienced surgeons with acceptable short-term outcomes, reduced invasiveness and good cosmetic effects.

摘要

简介

近年来,双端口腹腔镜胃切除术(DPLG)已广泛用于治疗胃癌。本研究报告了我们进行双端口腹腔镜远端胃切除术(DPLDG)的初步经验。

方法

自 2016 年 11 月至 2018 年 8 月,我院对 38 例连续患者进行了 DPLDG。观察结果包括 30 天发病率和死亡率、首次排气时间、首次口服液体饮食时间、首次口服半流质饮食时间、引流管拔除时间、视觉模拟评分(VAS)评分、术后 4 天恢复率、额外镇痛使用、住院时间和美容效果。

结果

平均手术时间为 191.6±44.4 分钟,术中平均出血量为 39.8±48.7ml,平均解剖淋巴结数为 38.3±13.7 个。1 例中转五孔腹腔镜手术,无术中并发症。术后首次排气时间平均为 45.3±18.0 小时。首次口服液体饮食时间平均为 56.7±30.4 小时。引流管拔除时间平均为 97.9±52.3 小时。术后 3 天的平均 VAS 评分为 2.3±0.7、2.0±0.6 和 1.6±0.5。共有 81.6%的入组患者符合术后 4 天恢复标准,15.8%的患者接受了额外镇痛。平均术后住院时间为 6.0±2.0 天。无死亡病例,30 天发病率为 13.2%。

结论

对于经验丰富的外科医生来说,DPLDG 是一种可行且安全的手术方法,具有可接受的短期结果、减少的侵袭性和良好的美容效果。

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