laparoscopically assisted distal gastrectomy 1

21 1 1009-6612 2016 01-0041 - 05 DOI 10. 13499 /j. cnki. fqjwkzz. 2016. 01. 041? 250012 2014 7 2015 2 21 27 laparoscopically assisted distal gastrectomy LADG 20 24 laparoscopically assisted total gastrectomy LATG LADG LATG R735. 2 A Comparative analysis of short-term outcomes between laparoscopy-assisted gastrectomy and open gastrectomy for gastric cancer HUANG Xin LIU Shao-zhuang YU Fei et al. Department of General Surgery Qilu Hospital of Shandong University Jinan 250012 China Abstract Objective To compare the efficacy of laparoscopy-assisted gastrectomy and open gastrectomy for gastric cancer and analyze the feasibility safety and effectiveness of laparoscopy-assisted gastrectomy. Methods This is a retrospective analysis of clinical data of patients who underwent gastrectomy from Jul. 2014 to Feb. 2015. 21 patients underwent open distal gastrectomy 27 patients underwent laparoscopically assisted distal gastrectomy 20 patients received open total gastrectomy and 24 patients received laparoscopically assisted total gastrectomy. The operation time blood loss postoperative hospital stay postoperative complications and so on were compared among the 4 groups. Results When performed laparoscopically distal and total gastrectomy both required longer operation time but resulted in significantly reduced blood loss and length of postoperative hospital stay and had faster gastrointestinal function recovery and removal of drainage tube. Conclusions Laparoscopy-assisted gastrectomy for gastric cancer is a safe reliable and effective procedure which has the advantage of mini incision little blood loss and fast recovery. It deserves to be recommended in the clinical application. Key words Stomach neoplasms Laparoscopy Laparotomy Comparative effectiveness research 1 1991 laparoscopically assisted distal gastrectomy 1 LADG 1. 1 1 D 2 2 2014 7 2015 2? E-mail husanyuan1962@ hotmail. com 1990 41

21 1 ODG 21 LADG 27 20 open total gastrectomy OTG OTG 24 laparoscopically assisted total gastrectomy LATG LATG open distal gastrectomy ODG 1 ST NCCN CCU LADG 1 2 TNM 7 2 1 2 1 x 珋 ± s n BMI n n kg /m 2 BⅠ BⅡ Ⅰ Ⅱ Ⅲ ODG 12 9 58. 6 ± 7. 5 22. 3 ± 2. 3 16 5 2 3 16 LADG 17 10 60. 7 ± 9. 0 23. 3 ± 2. 6 24 3 1 5 21 t /χ 2 0. 167 0. 778 1. 304 1. 371 0. 771 P 0. 683 0. 460 0. 200 0. 272 0. 680 2 x 珋 ± s n BMI n kg /m 2 Ⅰ Ⅱ Ⅲ OTG 12 8 63. 8 ± 8. 2 21. 9 ± 2. 2 1 2 17 LATG 18 6 61. 5 ± 7. 6 22. 0 ± 2. 2 1 1 22 t /χ 2 1. 131 0. 855 0. 179 0. 616 P 0. 287 0. 360 0. 810 0. 735 1. 2 1 3 15 cm 6 cm BⅠ BⅡ 6 cm D 2 BⅠ 1. 2. 2 LATG LADG BⅡ Roux-en-Y 1 2 3 4sa 4sb 4d 5 6 7 8a 9 11p 11d 12a 14v 1. 2. 1 LADG 10 mm 5 cm 4 Veress CO 2 6 cm 12 mmhg 10 mm Trocar Roux-en-Y 12 mm 5 cm 5 mm 5 mm 1 10 mm 1. 2. 3 ODG 15 cm Henle 1 14v 1 3 4d 4sb 5 6 Hem-o-lok 6 7 8a 9 11p 12a 14v BⅠ BⅡ 2 4sb 4d 1. 2. 4 OTG 11p ODG Hem-o-lok 1 2 3 4 5 6 7 8a 9 10 11p 11d 12a 14v 3 7 9 Roux-en-Y 8a 12a Hem-o-lok 42

21 1 1 Henle 2 3 Hem-o-lok 4 1. 3 2. 1 P < 0. 05 P < 0. 05 P > 0. 05 LADG LATG 3 4 1. 4 SPSS 18. 0 2. 2 ± x 珋 LADG LATG ± s t χ 2 P < 0. 05 P < 0. 05 3 4 2 3 x 珋 ± s t /min V /ml n ODG 212. 4 ± 33. 5 123. 3 ± 30. 1 20. 5 ± 4. 0 2. 8 ± 0. 8 11. 5 ± 3. 2 12. 8 ± 3. 2 LADG 258. 7 ± 41. 4 79. 3 ± 28. 7 20. 2 ± 3. 8 2. 3 ± 0. 7 9. 6 ± 1. 8 11. 0 ± 2. 1 t 4. 171 5. 129 0. 226 2. 443 2. 571 2. 391 P < 0. 001 < 0. 001 0. 822 0. 018 0. 013 0. 021 4 x 珋 ± s t /min V /ml n OTG 225. 5 ± 31. 2 164. 7 ± 34. 5 25. 2 ± 3. 6 3. 4 ± 1. 1 13. 2 ± 2. 7 14. 4 ± 2. 1 LATG 314. 8 ± 44. 0 105. 0 ± 38. 1 24. 0 ± 5. 0 2. 3 ± 0. 7 11. 8 ± 2. 3 13. 0 ± 2. 3 t 7. 613 5. 396 0. 921 3. 853 2. 185 2. 088 P < 0. 001 < 0. 001 0. 362 0. 000 0. 034 0. 043 2. 3 ODG 1 4. 8% LADG 1 3. 7% 3 OTG 1 5. 0% 1 5. 0% LATG 1 4. 2% 43

21 1 1 3 endoscopic mucosal re- 10 section EMR 15 NCCN Guidelines D 1 D 2 2 endoscopic submucosal dissection ESD 4 LADG LATG 11 12 5-6 D 2 LATG LADG 7-8 9 1 ODG LADG OTG LATG 2 3 13-14 4 LADG LATG Hem-o-lok 44

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