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目的:探讨完全腹腔镜下行全胃切除术的临床价值。方法:回顾性分析2013年5月—2014年9月收治的66例行腹腔镜全胃切除术的胃上部癌患者临床资料,16例行全腔镜下根治性全胃切除术(全腹腔镜组),50例行腹腔镜辅助下根治性全胃切除术(腹腔镜辅助组),比较两组患者术前资料、术中指标、术后情况。结果:两组患者术前资料具有可比性。与腹腔镜辅助组比较,全腹腔镜组手术时间延长、住院费用增高(均P<0.05),但在手术切口长度、术后疼痛、术后恢复时间、住院时间、术后并发症发生率方面明显优于前者(均P<0.05);两组在术中出血、两端切缘距离、淋巴结清扫数目等无统计学差异(均P>0.05)。结论:全腹腔镜下行全胃切除术安全可行,可作为胃癌外科治疗的一种术式及未来微创理念发展的方向。
Objective: To investigate the clinical value of total laparoscopic total gastrectomy. Methods: The clinical data of 66 patients with upper gastric cancer undergoing total laparoscopic total gastrectomy from May 2013 to September 2014 were analyzed retrospectively. Totally 16 patients underwent total laparoscopic radical gastrectomy Group). Fifty patients underwent laparoscopic radical gastrectomy (laparoscopic assistant group). The preoperative data, intraoperative indexes and postoperative condition were compared between the two groups. Results: The preoperative data of two groups of patients were comparable. Compared with the laparoscopic auxiliary group, the total laparoscopic group had longer operation time and higher hospitalization cost (all P <0.05), but there was no significant difference in the length of incision, postoperative pain, postoperative recovery time, hospitalization time, postoperative complication rate (All P <0.05). There was no significant difference between the two groups in intraoperative bleeding, the distance between the two sides and the number of lymph node dissection (all P> 0.05). CONCLUSION: Total laparoscopic total gastrectomy is safe and feasible, which can be used as a surgical treatment of gastric cancer and the future direction of minimally invasive surgery.