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目的:比较全腔镜胃癌根治术(TLG)与传统腔镜辅助胃癌根治术(LAG)全胃切除的安全性及可行性。方法:回顾性分析2012年1月至2014年3月我院30例TLG和32例LAG患者的临床资料。结果:62例手术均获成功,无1例中转开腹。与传统的LAG组相比,TLG组吻合时间、清扫淋巴结总数均无明显差异。但术中出血量明显减少,切口长度明显减小,下床活动时间、住院时间明显缩短。且术后患者的疼痛评分明显减轻。TLG组均未出现吻合口漏、吻合口狭窄或吻合口出血等吻合口相关并发症。LAG组1例出现吻合口漏,1例出现吻合口狭窄。结论:全腔镜下吻合技术及小切口腔镜辅助吻合技术在腹腔镜胃癌根治术中均安全可行,TLG组与LAG组相比具有创伤小、出血少、恢复快、住院时间短及疼痛感轻等优势,近期效果显著。
Objective: To compare the safety and feasibility of total gastrectomy with lumpectomy (TLG) and traditional endoscopic gastrectomy (LAG). Methods: The clinical data of 30 TLG patients and 32 LAG patients in our hospital from January 2012 to March 2014 were analyzed retrospectively. Results: All the 62 surgeries were successful. None of them underwent laparotomy. Compared with the traditional LAG group, there was no significant difference between the TLG group and the total lymph node dissection. However, the amount of intraoperative bleeding was significantly reduced incision length was significantly reduced out of bed activities, hospitalization was significantly shorter. Postoperative pain scores were significantly reduced. TLG group did not appear anastomotic leakage, anastomotic stenosis or anastomotic bleeding and other anastomotic complications. Anastomotic leakage occurred in 1 case in LAG group and anastomotic stenosis occurred in 1 case. CONCLUSIONS: A total anastomosis technique combined with small-incision endoscopic assisted anastomosis is safe and feasible in laparoscopic radical gastrectomy. Compared with LAG group, TLG group has less trauma, less bleeding, faster recovery, shorter hospital stay and pain Light advantages, the recent significant effect.