全腹腔镜与腹腔镜辅助全胃切除术对胃上部癌患者的治疗效果对比

目的 分析全腹腔镜与腹腔镜辅助全胃切除术对胃上部癌患者的治疗效果.方法 选择胃上部癌患者94例,根据治疗方式不同将患者分为对照组(n=47)和研究组(n=47),对照组行腹腔镜辅助全胃切除术,研究组行全腹腔镜全胃切除术,比较两组患者的术后凝血功能指标、视觉模拟评分(VAS)、手术情况、术后恢复及并发症情况.结果 术后两组患者的凝血功能指标(APTT、Fg、D-D)均升高,但两组比较差异无统计学意义(P﹥0.05);研究组患者VAS评分低于对照组,差异有统计学意义(P﹤0.05);研究组术中切口长度短于对照组,差异有统计学意义(P﹤0.01);两组的手术时间、术中出血量、淋巴结清扫数目比较,差异无统计学意义(P﹥0.05);研究组患者术后下床活动时间、肛门排气时间、进食流质时间、住院时间均短于对照组,差异有统计学意义(P﹤0.01);两组患者的并发症发生情况比较,差异无统计学意义(P﹥0.05).结论 全腹腔镜全胃切除术对胃上部癌患者的治疗效果优于腹腔镜辅助全胃切除术,值得临床推广应用.

Comparison of totally laparoscopic total gastrectomy and laparoscopic-assisted total gastrectomy in patients with upper gastric cancer

Objective To analyze the therapeutic effect of totally laparoscopic total gastrectomy (TLTG) and laparo-scopic-assisted total gastrectomy (LATG) in patients with upper gastric cancer. Method 94 patients with upper gastric cancer were included in the study, and were divided as control group (n=47) or study group (n=47), administered with LATG or TLTG, respectively, and the postoperative blood coagulation function index level, visual analogue scale (VAS), surgery measures, postoperative recovery and complications in the two groups were compared. Result After surgery, the blood coagulation function index (APTT, Fg, D-D) of the two groups were both elevated, though no difference was ob-served (P>0.05);The VAS score of study group was significantly lower than that of the control group (P<0.05), and the study group had shorter incision length compared with the control group (P<0.01); the operative time, intraoperative blood loss, number of resected lymph nodes of the two groups were similar (P>0.05);the study group had significantly shorter ambulation time, anal flatus time, time of liquid diet, and hospital stay than that of the control group (P<0.01);while there was no statistically significant difference in regard of complications in the two groups (P>0.05). Conclusion TLTG, which is superior to LATG, is clinically applicable in patients with upper gastric cancer.