Clinical Data Analysis Of Totally Laparoscopic And Laparoscopic Assisted Radical Gastrectomy For Distal Gastrectomy

Objective To explore the clinical advantages of total laparoscopic distal gastrectomy(TLDG)and laparoscopic-assisted distal gastrectomy(LADG)for distal gastric cancer by analyzing the data of two groups of patients after total laparoscopic distal gastrectomy(TLDG)and laparoscopic-assisted distal gastrectomy(LADG).Methods A retrospective analysis was made of 60 patients who underwent complete laparoscopic radical distal gastrectomy and laparoscopic-assisted distal gastric cancer from January 2015 to October 2018.The patients were divided into two groups according to the different surgical methods(30 cases in each group),namely total laparoscopic group(TLDG)and laparoscopic assisted group(LADG).The preoperative general data(age,sex,BMI,ASA,history of abdominal surgery),clinical and pathological characteristics(tumor diameter,differentiation degree,TNM stage)and intraoperative data(tumor margin)of the two groups were compared.Operative time,intraoperative bleeding volume,number of lymph nodes removed,postoperative data(postoperative analgesia time,postoperative hospital stay,first exhaust time,first time out of bed),postoperative inflammatory indicators,postoperative complications.In order to exclude the difference,the selected cases were performed by the same surgeon.More than 100 cases of laparoscopic radical gastrectomy have been completed.Results Visit the video of the operation: All the operations were successfully completed.(1)There was no significant difference in the preoperative general data(age,sex,BMI,ASA,history of abdominal surgery)between the two groups(P > 0.05),nor was there any difference in the pathological characteristics(tumor diameter,degree of differentiation,TNM stage)between the two groups.Significant difference(P > 0.05);(2)In intraoperative data comparison,there was no significant difference in tumor margin,number of lymph node dissection and operative bleeding between the two groups(P> 0.05);but the operation time of laparoscopic assisted group was shorter than that of the whole laparoscopic group(P< 0.05);(3)In postoperative data,total laparoscopic distal gastrectomy used for postoperative analgesia.The time of first exhaust after operation,the time of first getting out of bed after operation,and the time of hospitalization after operation were significantly better than those in laparoscopic assisted group(P < 0.05),but there was no significant difference in the indexes of inflammationand complications between the two groups(P > 0.05).Conclusion Total laparoscopic radical distal gastrectomy and laparoscopic-assisted radical distal gastrectomy are safe and feasible.Complete laparoscopic radical distal gastrectomy has the advantages of minimal trauma,rapid recovery,good cosmetic effect and short hospitalization time.