【摘要】 目的 :研究全腹腔镜下改良三角吻合技术治疗远端胃癌临床疗效。方法 :2013年12月—2017年10月102例远端胃癌患者,采用全腹腔镜下改良三角吻合远端胃癌根治术(治疗组)42例,采用传统腹腔镜辅助下远端胃切除术(对照组)60例,将两组患者的一般临床资料和评估指标进行对比。结果:两组患者在年龄、肿瘤分期、性别等具有可比性。治疗组手术时间、术后住院时间、术后镇痛剂用量、术中出血量、术后进食时间、术后排气时间、术后下地活动时间均短于对照组(P<0.05)。在消化道重建时长、淋巴结清扫数目、肿瘤距上下切缘距离、术后并发症等两组无明显差异(P>0.05)。结论:腹腔镜三角吻合技术治疗远端胃癌安全可行,临床效果较好。更多还原

【Abstract】 Objective: To study the effect of clinical treatment of patients with distal gastric cancer by total laparoscopic modified triangular anastomosis. Methods: The clinical data of 102 patients with distal gastric cancer undergoing surgery from December 2013 to October 2017 in Department of General Surgery, Central Hospital of Longgang, Shenzhen were retrospectively analyzed.Among them, 42 cases were treated by total laparoscopic modified triangular anastomosis of distal gastric cancer(treatment group), 60 cases were treated by conventional laparoscopic assisted distal gastrectomy(control group). The general clinical data and evaluation indicators of two groups patients were compared. Results: The age, tumor stage, gender and other aspects were not significantlydifferent between groups(P >0.05). Compared with the control group, the operation time in the treatment group(121.3±13.9 min) was shorter than that in the control group(136.3±21.9 min); The time of postoperative hospital stay in the treatment group(8.2±1.6 d) was shorter than that of the control group(11.3±2.9 d); The amount of postoperative analgesic agent(1.8±1.4) was less than that of the control group(3.8±1.7); The amount of bleeding during the operation(86.3±39.8 ml) was less than that of the control group(186.3±59.8 ml); The start eating time(4.4±1.5 d) was shorter than that of the control group(6.1±1.7 d); The exhaust time(2.7±0.6 d) was shorter than that of the control group(3.4±0.5 d). The activity time of going to the ground(4.1±1.5 d) was shorter than that of the control group(6.9±1.5 d), All the differences were significant(P <0.05). There was no significant difference between the two groups in the time of digestive tract reconstruction, the number of lymph node dissection,the distance between the tumor and the upper and lower incision margins, postoperative complications and other indicators(P>0.05). Conclusion: The application of total laparoscopic triangular anastomosis in the treatment of distal gastric cancer is technically safe and feasible,a nd the short-term effect after operation is better. But the operation indications must be controlled strictly.The long-term efficacy needs further accumulation of cases and collect enough evidence to verify.更多还原