【摘要】 目的探讨"单孔+1"技术在远端胃癌关于加速康复外科的可行性和优势。方法回顾性收集90例pT1-4aNXM0远端GC经腹腔镜手术的患者,回顾性病例采用SPASS 1∶2进行随机匹配,其中"单孔+1"组30例,传统5孔腔镜组(CLS)60例。比较两组术中观察指标(手术时间、术中出血量、切口长度)、术后观察指标(术后首次下地时间、首次排气时间、腹腔引流管拔除时间、术后前3天疼痛评分、住院天数、肿瘤最大径、淋巴结清扫枚数及疼痛评分)。结果"单孔+1"组总切口长度更短,首次下地时间及首次排气时间更早,术后疼痛更轻,术后住院时间更短(P <0.05)。"单孔+1"组的术后出院时间小于CLS组(P <0.05)。术后第2日复查,发现"单孔+1"组的总蛋白、白蛋白均高于CLS组(P <0.05),CRP指标低于CLS组(P <0.05)。两组患者的淋巴结清扫个数、淋巴结转移个数及术后并发症发生率、术前总蛋白、白蛋白及CRP指标无统计学差异(P> 0.05)。结论 "单孔+1"的技术具有良好的可操作性及普及性,该技术在同等根治度的前提下,不仅减少术后躯体疼痛,还可以缩短住院时间。同时,手术损伤更小,对患者术后营养状态的保护更好。更多还原

【Abstract】 Objective To investigate the feasibility and advantages of single incision laparoscopic surgery Plus One Assist Port(SILS+1-AP) technique in accelerating rehabilitation surgery in patients with distal gastric cancer. Methods A retrospective collection of 90 patients with pT1-4aNXM0 distal GC underwent laparoscopic surgery, random matched according to 1:2, including 30 cases of SILS+1-AP group, and 60 example of traditional 5-hole endoscopy group(CLS). The intraoperative observation indexes(operative time, intraoperative blood loss, and incision length) were compared between the two groups. Postoperative observations(first time after surgery, first exhaust time, extraction time of abdominal drainage tube, pain score, hospitalization days, maximum tumor diameter, number of lymph node dissections, and pain score). Results The total incision length of the SILS+1-AP group was shorter, the time of the first grounding and exhaust time were earlier, the postoperative pain was lighter, and the postoperative hospital stay was shorter(all P<0.05). The postoperative discharge time of the SILS+1-AP group was smaller than that of the CLS group(P<0.05). On the second day, for the SILS+1-AP group, the total protein and albumin were higher than those in the CLS group, but the CRP index was lower than that in the CLS group(all P<0.05). Conclusions The SILS+1-AP technique has good operability and popularity. Under the premise of the same radical degree, this technology not only reduces postoperative somatic pain, but also restores time faster and shortens hospital stay. At the same time, the surgical strike is smaller and the protection of the patient’s nutritional status is better.更多还原