完全腹腔镜与腹腔镜辅助进展期远端胃癌根治术的近期疗效比较

将腹腔镜下远端胃癌 D2根治术的61例患者随机分为 TLDG 组与 LADG 组，对比分析两组患者的临床资料。TLDG 组32例中行 BⅠ式吻合（残胃十二指肠三角吻合）21例，残胃空肠 Roux-en-Y 吻合11例；LADG 组胃癌根治29例中行 BⅠ式吻合20例，残胃空肠 Roux-en-Y 吻合9例。两组在平均手术时间、术中出血量、平均肿瘤下切缘、平均肿瘤上切缘、切除淋巴结枚数方面相比差异无统计学意义。TLDG组术后未使用镇痛药，LADG 组平均使用镇痛药（2.5±0.4） d（P <0.05）；TLDG 组在术后通气时间、术后第1次下床时间方面明显短于 LADG 组，差异有统计学意义（ P <0.05）；两组术后早期并发症相比差异无统计学意义。

A comparison of short-term outcome between totally laparoscopic and laparoscopic-assisted distal gastrectomy for advanced gastric cancer

61 patients who have undergone laparoscopic D2 radical distal gastrectomy were randomly divided into totally laparoscopic group(TLDG)and laparoscopic-assisted group(LADG). The clinical data of the two groups were analyzed retrospectively. There were 21 cases who underwent anastomosis of Billoth Ⅰ(residual stomach and duodenum delta-shaped anastomosis)and 11 cases who underwent residual stomach and jejunum Roux-en-Y anas-tomosis in TLDG group. In LADG group there were 20 cases who underwent anastomosis of Billoth Ⅰand 9 cases who underwent residual stomach and jejunum Roux-en-Y anastomosis. There was no significant difference between the two groups in the operative time,the blood loss,the distance from distal surgical margin to tumor,the distance from proximal surgical margin and the number of harvested lymph nodes. The analgesic was only used in laparo-scopic-assisted group for(2. 5 ± 0. 4)d( P < 0. 05). The significant difference was observed between the two groups in time of gastrointestinal function recovery and out of bed activity(P < 0. 05). There was no significant difference between the two groups in complication rate.