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目的 探究远端胃癌根治,采用全腹腔镜胃十二指肠三角吻合术的近期疗效评价.方法 选取在2015G12-2016G8期间,在我院根治远端胃癌的患者56例,根据患者的家庭经济条件及个人意愿选择手术方式,分为腹腔镜组及开腹组,腹腔镜组28例患者行全腹腔镜胃癌根治胃十二指肠三角吻合术,开腹组28例选择剖腹远端胃癌根治术(BillrothⅠ吻合术),两组患者的手术过程均由同一组医生操作完成,观察两组患者术后情况(切口情况、术中出血量、住院时间、恢复情况等).结果两组患者均顺利完成了手术,腹腔镜组术后情况(切口情况、术中出血量、住院时间、恢复情况等)明显优于开腹组,腹腔镜组仅有切口感染1例;开腹组有2例切口感染、2例肺部感染、1例术后梗阻、2例胃排空障碍.两组患者术后情况差异显著(P<005),有统计学意义.结论 远端胃癌根治采用全腹腔镜胃癌根治胃十二指肠三角吻合术更加安全,在手术近期效果上与开腹手术效果无明显差异基础上,具有术中出血量少,术后恢复快,切口更小,疤痕更小的优点,但微创手术的远期效果还需进行进一步的观察.
Objective To investigate the curative effect of radical laparoscopic gastroduodenal anastomosis in the treatment of distal gastric cancer.Methods Fifty-six patients with radical gastric cancer were treated in our hospital during 2015G12-2016G8.According to the family’s economic conditions 28 patients undergoing laparoscopic radical gastrectomy underwent gastroduodenal anastomosis undergoing total laparoscopic radical gastrectomy and 28 underwent laparotomy distal gastrectomy undergoing laparoscopic radical gastrectomy (Billroth Ⅰ anastomosis), the operation of the two groups of patients were completed by the same group of doctors to observe the postoperative condition (incision, blood loss, hospital stay, recovery, etc.) in both groups.Results Both groups were successful After operation, laparoscopic surgery group (incision, intraoperative blood loss, hospital stay, recovery, etc.) were significantly better than those in laparotomy group, only laparotomy group incision infection in 1 case; laparotomy group had 2 cases of incision 2 cases of pulmonary infection, 1 case of postoperative obstruction and 2 cases of gastric emptying failure.The difference between the two groups after operation was significant (P <005), which was statistically significant.Conclusion The treatment of distal gastric cancer with total laparoscopic gastric cancer Radical stomach duodenum Angle anastomosis more secure, the effect of surgery in the near future and open surgery no significant difference in the basis of the effect, with less blood loss, postoperative recovery faster, smaller incision, scar smaller advantage, but minimally invasive surgery far Period effect needs further observation.