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单切口加单孔腹腔镜胃癌切除术与传统多孔腹腔镜辅助胃癌切除术的对比:一项回顾性研究

Single-incision plus one-port laparoscopic gastrectomy versus conventional multi-port laparoscopy-assisted gastrectomy for gastric cancer: a retrospective study.

作者信息

Du Guang-Sheng, Jiang En-Lai, Qiu Yuan, Wang Wen-Sheng, Yin Jiu-Heng, Wang Shuai, Li Yun-Bo, Chen Yi-Hui, Yang Hua, Xiao Wei-Dong

机构信息

Department of General Surgery, Xinqiao Hospital, Army Medical University, Xinqiaozhengjie 183, Shapingba District, Chongqing, 400037, People's Republic of China.

出版信息

Surg Endosc. 2022 May;36(5):3298-3307. doi: 10.1007/s00464-021-08643-3. Epub 2021 Jul 27.

Abstract

BACKGROUND

We compared short-term perioperative outcomes after single-incision plus one-port laparoscopic gastrectomy (SILG+1) and conventional multi-port laparoscopy-assisted gastrectomy (C-LAG) for gastric cancer.

METHODS

The work was conducted between August 2017 and October 2019. A total of 90 patients with early or advanced gastric cancer were retrospectively analyzed: 43 patients of which underwent SILG+1, and 47 of which underwent C-LAG, respectively. These were divided into two groups: the total gastrectomy group (SILT+1 and C-LATG) and the distal gastrectomy group (SILD + 1 and C-LADG). The demographics, tumor characteristics, postoperative outcomes, and short-term complications of all enrolled patients were summarized and statistically analyzed.

RESULTS

The mean incision length in SILT+1 group was 5.40 cm shorter than that in C-LATG group (3.15 ± 0.43 vs. 8.55 ± 2.72, P < 0.001). This comparison between the SILD + 1 and the C-LADG group produced comparable results. The SILT+1 group underwent a 56.32 min longer operation than the C-LATG group (273.03 ± 66.80 vs. 216.71 ± 82.61, P = 0.0205). SILG+1 group had better postoperative visual analog scale (VAS) and cosmetic score than those of the C-LATG group (P < 0.05). There were no significant differences in preoperative demographics or 30-day postoperative complication rates between the SILG+1 and C-LAG groups. Tumor-related index, including mass size, histological type, number of retrieved lymph nodes, pathological tumor-node-metastasis (TNM) stage, and proximal and distal edges were all equivalent between the SILG+1 and the C-LAG group.

CONCLUSIONS

This retrospective study demonstrates the safety and feasibility of SILG+1 with D1+ or D2 lymphadenectomy for the treatment of early and advanced gastric cancers, compared with C-LAG.

摘要

背景

我们比较了单切口加单孔腹腔镜胃癌根治术(SILG+1)与传统多孔腹腔镜辅助胃癌根治术(C-LAG)的短期围手术期结果。

方法

研究于2017年8月至2019年10月进行。对90例早期或进展期胃癌患者进行回顾性分析:其中43例行SILG+1手术,47例行C-LAG手术。这些患者分为两组:全胃切除组(SILT+1和C-LATG)和远端胃切除组(SILD + 1和C-LADG)。总结并统计分析所有入组患者的人口统计学资料、肿瘤特征、术后结果和短期并发症。

结果

SILT+1组的平均切口长度比C-LATG组短5.40 cm(3.15±0.43 vs. 8.55±2.72,P < 0.001)。SILD + 1组与C-LADG组的比较结果相似。SILT+1组的手术时间比C-LATG组长56.32分钟(273.03±66.80 vs. 216.71±82.61,P = 0.0205)。SILG+1组术后视觉模拟评分(VAS)和美容评分均优于C-LATG组(P < 0.05)。SILG+1组与C-LAG组术前人口统计学资料或术后30天并发症发生率无显著差异。SILG+1组与C-LAG组的肿瘤相关指标,包括肿块大小、组织学类型、获取的淋巴结数量、病理肿瘤-淋巴结-转移(TNM)分期以及切缘近端和远端均相当。

结论

这项回顾性研究表明,与C-LAG相比,SILG+1联合D1+或D2淋巴结清扫术治疗早期和进展期胃癌具有安全性和可行性。

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