临床研究(Clinical Research)

完全腹腔镜与腹腔镜辅助胃癌根治术近期疗效比较

Published at: 2017年第26卷第10期

潘华 1 , 黄俊 1 , 罗洪亮 1 , 朱正明 1
1 南昌大学第二附属医院 胃肠外科,江西 南昌 330006
通讯作者 正明 朱 Email: zzm8654@163.com
DOI: 10.3978/j.issn.1005-6947.2017.10.015
基金:

摘要

目的:探讨完全腹腔镜胃癌根治术(TLG)与腹腔镜辅助胃癌根治术的近期疗效。方法:收集2013年5月—2016年5月期间在南昌大学第二附属医院胃肠外科治疗的435例胃癌患者资料,其中207例行TLG(TLG组),228例行LAG(LAG组)。比较两组患者相关临床指标。结果:两组患者术前资料具有可比性,所有患者的手术均成功完成,无中转开腹。与LAG组比较,TLG组淋巴结清扫数目差异无统计学意义(23.64枚vs. 24.69枚,P=0.14),手术时间(204.34 min vs. 214.65 min)、吻合时间(33.00 min vs. 38.86 min)、术中出血量(185.20 mL vs. 210.02 mL)、切口长度(3.88 cm vs. 8.05 cm)、术后下床活动时间(1.71 d vs. 2.59 d)、肛门排气时间(2.63 d vs. 3.51 d)、术后第1、3天疼痛评分(3.01分vs. 4.86分;1.88分vs. 3.53分)、术后住院时间(12.23 d vs. 15.96 d)均明显减少(均P<0.05)。TLG组与LAG组患者术后并发症发生率(2.4% vs.2.6%,P=0.89)以及随访12个月的中位生存时间(11.07个月vs. 10.91个月)均无统计学差异(均P>0.05)。结论:TLG安全、可行,且近期疗效优于LAG。


Comparison of short-term outcomes of totally laparoscopic and laparoscopy-assisted gastrectomy

Abstract

Objective: To compare the short-term efficacy of totally laparoscopic gastrectomy (TLG) and laparoscopy-assisted gastrectomy (LAG). Methods: The data of 435 patients with gastric cancer treated in the Department of Gastrointestinal Surgery of the Second Affiliated Hospital, Nanchang University from May 2013 to May 2016 were collected. Of the patients, 207 cases underwent TLG (TLG group), and 228 cases underwent LAG (LAG group). The main clinical variables between the two groups of patients were compared. Results: The preoperative data between the two groups of patients were comparable, and operations were successfully performed in all cases without any open conversion. In TLG group compared with LAG group, the number of resected lymph nodes showed significant difference (23.64 vs. 24.69, P=0.14), while the operative time (204.34 min vs. 214.65 min), anastomosis time (33.00 min vs. 38.86 min), intraoperative blood loss (185.20 mL vs. 210.02 mL), and the incision length (3.88 cm vs. 8.05 cm), time to postoperative ambulation (1.71 d vs. 2.59 d), time to first gas passage (2.63 d vs. 3.51 d), the first and third day postoperative pain score (3.01 vs. 4.86; 1.88 vs. 3.53), and length of postoperative hospital stay (12.23 d vs. 15.96 d ) were all significantly reduced (all P<0.05). There were no significant differences in incidence of postoperative complications (2.4% vs. 2.6%, P=0.89) and median survival time during a 12-month follow-up (11.07 months vs. 10.91 months). Conclusion: TLG is safe and effective, and its short-term efficacy in superior to that of LAG.


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引用

引用本文: 华 潘, 俊 黄, 洪亮 罗, 正明 朱. 完全腹腔镜与腹腔镜辅助胃癌根治术近期疗效比较[J]. 中国普通外科杂志, 2017, 26(10): 1316-1323.
Cite this article as: PAN Hua, HUANG Jun, LUO Hongliang, ZHU Zhengming . Comparison of short-term outcomes of totally laparoscopic and laparoscopy-assisted gastrectomy[J]. Chin J Gen Surg, 2017, 26(10): 1316-1323.