两孔法全腹腔镜远端胃癌根治术的应用价值及经验总结

目的:探讨两孔法全腹腔镜远端胃癌根治术的临床应用价值及初步经验。方法:回顾分析2018年1月至2019年9月收治的25例行两孔法全腹腔镜远端胃癌根治术患者的临床资料(两孔组),并采用1:1的倾向性评分匹配法从同期50例接受五孔法全腹腔镜远端胃癌根治术的患者中选出35例(五孔组)作为对照,比较分析两组围手术期指标及术后30 d内并发症发生率。结果:两组患者围手术期均未发生严重并发症,无死亡病例。两孔组总切口长度更短,首次下床活动时间、首次排气时间更早,术后疼痛更轻,美容评分更高,住院时间更短,两组相比差异有统计学意义(P<0.05)。结论:两孔法全腹腔镜远端胃癌根治术治疗T3以内、直径<3 cm的胃癌是安全、可行的,在术后恢复、减轻疼痛及美容效果等方面具有优势。

Application value and experience of dual-port laparoscopic distal gastrectomy for gastric cancer

Objective:To investigate the clinical value and preliminary experience of dual-port laparoscopic distal gastrectomy for distal radical gastrectomy.Methods:The clinical data of 25 patients with distal gastric cancer(dual-port group)who underwent dual-port surgery from Jan.2018 to Sep.2019 were retrospectively analyzed.Thirty-five patients(five-port group)were selected from 50 patients who underwent radical distal gastrectomy under complete laparoscopy at the same time by 1:1 propensity score matching method.The operative time,blood loss,number of retrieved lymph nodes,total length of incision,time to resume normal activities,time of first postoperative flatus,time of first liquid diet intake,postoperative hospital stay,pain score,cosmetic scale and postoperative 30-day complication rate of patients in two groups were compared.Results:No serious complication or death were observed in perioperative period.The total length of incision was shorter,time to resume normal activities,time of first postoperative flatus was earlier,the pain was lighter and the postoperative cosmetic score was higher,the hospitalization time was shorter in the dual-port group(P<0.05).There was no significant difference in the other indicators.Conclusions:Dual-port laparoscopic distal gastrectomy is safe and feasible for the treatment of gastric cancer less than 3 cm in diameter within T3 and with advantages of faster postoperative recovery,reducing pain and better cosmetic outcomes.