| Objective:This paper aims to explore the feasibility,safety and replicability of membrane anatomy theory in D2 radical surgery for advanced gastric cancer,and to explore the advantages and disadvantages of 3D laparoscopic D2 radical surgery for gastric cancer and its clinical effect under the support of this theory.Methods: In this study,sixty patients with advanced stomach cancer were completed by laparoscopy(3D/2D)in Jilin Provincial People’s Hospital from June 2018 to December2020 were collected,including 32 patients in the study group and 28 patients in the control group.The P value of general data difference was greater than 0.05,which was of comparative significance.Patients in both groups were performed under the guidance of membrane anatomy theory.During the above-mentioned operation,an audio-visual system is used to record the whole operation process.After the operation,all personnel participating in the operation watch the operation replay in the classroom in the treatment area.According to the preoperative,intraoperative and postoperative conditions,the corresponding data will be collected including the following aspects: 1.General information about the preoperative patient.2.Intraoperative laparoscopy free,cleaning time,surgical blood loss,postoperative pathological lymphatic sorting number,postoperative pathological classification,postoperative exhaust time,digestive tract function recovery(total liquid food)time,whether Complications,the total number of days spent in hospital,and overall hospital expenses.3.The picture data of the gross specimen removed after the operation and the integrity of the mesangium are verified by observation under a microscope after pathological processing,and the relevant data and data observed are collected.4.Through the questionnaire satisfaction survey method,the surgeon is asked to score,and evaluate the workload,operating experience,imaging clarity,visual effect and workload evaluation of the nurses of the two surgical methods.Use data software for data analysis to explore the clinical value of 3D laparoscopy in radical gastric cancer surgery.Results: From the collected postoperative gross pathological specimen pictures and the pathological slices obtained after pathological processing under the microscope,it can be found that the integrity of the membrane resected after 3D laparoscopic surgery is better,and the integrity rate is higher in 24 cases(75%).In terms of surgery,it takes shorter time under the microscope during surgery(185.03±22.96 min vs 232.29±41.41 min,P<0.05),and intraoperative bleeding is also less(123.28±47.29 ml vs 154.86±52.08 ml,P<0.05),The number of lymph node dissections was large(24.09±3.28 vs 20.14±5.62,P<0.05),the patient’s postoperative recovery was faster and the overall hospitalization time was greatly shortened(16.68 ± 3.86 days vs 19.21 ± 4.89 days,P<0.05),In terms of hospitalization expenses,the average expenditure of the study group was lower(79998.53± 18850.51 yuan vs 88347.39 ± 17162.38 yuan,P>0.05),but the difference was not statistically significant.Complications(x2 = 4.499,P<0.05)included 4 cases(12.5%)in the 3D group and 10 cases(35.7%)in the 2D group.Among them,the probability of gastroplegia was(6.3% vs 25%,x2 = 4.118,P<0.05),and the probability of incision infection was(6.3% vs 10.6%,x2 = 0.533,P>0.05).The totally situation of complication in study group is more better compared with control group.According to the scores of the questionnaire filled out by doctors and nurses,there is no meaningful difference in the workload of the surgeon,and the difficulty of the operation of3 D laparoscopy is even better(3.80±0.63 points vs.3.40±0.51 points,P>0.05;4.30±0.67 points vs3.5±0.707 points P<0.05).In terms of imaging clarity and visual effects,the study group was better than the control group(4.70±0.48 points vs3.30±0.48 points,P<0.05;4.00±1.05 points vs3.00±0.67 points,P<0.05).The nurse believed that there was no actual difference in the workload between the study group and the control group(3.80±0.84 points vs 3.14±0.67,P>0.05)Conclusion:From the theoretical study to the actual surgical application process,the theory of membrane anatomy is feasible,safe and reproducible in D2 radical resection of advanced gastric cancer.3D laparoscopy can better restore the concept of membrane anatomy.And it also has certain advantages in intraoperative and postoperative related aspects.The results of the medical care scores are also consistent with the conclusions obtained.It is safe and reliable,and the user experience is better than traditional 2D laparoscopy.It is worthy of promotion and popularization in medical institutions. |
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