摘要
目的比较3D腹腔镜下完全腹腔镜根治性全胃切除术(TLTG)与腔镜辅助根治性全胃切除术(LATG)治疗食管胃结合部癌的短期疗效。方法回顾性分析上海市东方医院胃肠外科2017年1月至2020年9月间116例食管胃结合部癌行3D腹腔镜下根治性全胃切除术的临床资料,分为全腔镜组及腔镜辅助组,通过1∶1倾向性评分配对进行匹配,筛选出其中各48例病例,比较两组间的短期疗效。结果两组所有病例均为R0切除。全腔镜组的术后VAS疼痛评分[术后第一天为(6.12±1.08)分,术后第3天为(3.52±0.95)分]及手术切口长度[(6.04±1.41)cm]明显低于腔镜辅助组,差异存在统计学意义(P<0.05)。而术中出血量、手术时间、食道空肠吻合时间、术后排气时间、术后进食时间、术后住院时间、术后病理情况及并发症发生情况等结果差异无统计学意义(P>0.05)。结论3D腹腔镜下TLTG的创伤更小,术后疼痛更轻,腹腔镜下食管空肠吻合时间与腔镜辅助手术耗时相当,且并不增加吻合口并发症的发生率,值得推广应用。
Objective To make a comparison of the short-term efficacy between totally laparoscopic total gastrectomy(TLTG)and laparoscopy-assisted total gastrectomy(LATG)with 3D laparoscopy in the treatment of esophagogastric junction cancer.Methods The clinical data of 116 patients with esophagogastric junction cancer who underwent total gastrectomy with 3D laparoscopy from January 2017 to September 2020 in Gastrointestinal Surgery Department of Shanghai East Hospital were analyzed retrospectively.The patients were divided into full endoscopic group(TLTG)and laparoscopy-assisted group(LATG)by the method of propensity score matching with 48 cases in each group.The short-term efficacy was compared between the two groups.Results All the cases in two groups were treated with R0 resection.The scores of Visual Analogue Scale of one day the three days after operation in TLTG group were 6.12±1.08 and 3.52±0.95 respectively,which were significantly lower than those in the LATG group(P<0.05).And the incision length of the patients in TLTG group was(6.04±1.41)cm,which was shorter than that of LATG group.However,there was no significant difference between the intraoperative blood loss,operation time,time of esophagojejunostomy,time of taking food,time of stay and postoperative complications(P>0.05).Conclusions TLTG with 3D laparoscopy has the advantages of small trauma and light pain,which is worthy of promotion.
作者
严东羿
张顺
袁彪
杨飖
尹华
蒋小华
宋纯
YAN Dongyi;ZHANG Shun;YUAN Biao;YANG Yao;YIN Hua;JIANG Xiaohua;SONG Chun(Department of Gastrointestinal Surgery, Shanghai East Hospital, Shanghai 200123,China)
出处
《中国肿瘤外科杂志》
CAS
2021年第3期261-266,共6页
Chinese Journal of Surgical Oncology
基金
上海市浦东新区卫健委特色专病项目(PWZzb2017-05)
国家自然科学基金面上项目(81672733)。
关键词
食管胃结合部癌
完全腹腔镜全胃切除术
腹腔镜辅助
倾向性评分匹配
Esophagogastric junction cancer
Totally laparoscopictotal gastrectomy
Laparoscopy-assisted
Propensity-score matching
Complications