| Objective: This study aimed to compare the efficacy of total laparoscopic radical gastrectomy(TLTG)and laparoscopic assisted radical gastrectomy(LATG).Methods: Retrospective analysis of the First Affiliated Hospital of Wannan Medical College from August 2017 to December 2019 and complete laparoscopic radical gastrectomy(TLTG)in the gastrointestinal surgery of Yijishan Hospital,First Affiliated Hospital of Wannan College Clinical data of 80 patients with upper gastric cancer who underwent laparoscopic assisted radical total gastrectomy(LATG).Complete laparoscopic radical gastrectomy(TLTG)was defined as the first group(n = 40);laparoscopic assisted radical gastrectomy(LATG)was defined as the second group(n =40).Comparison of tumor and demographic characteristics,average bleeding volume,average operation time,number of lymph node dissection,length of surgical incision,length of postoperative pain,postoperative pain score,anal exhaust time,time to get out of bed,length of postoperative hospital stay and total cost of hospitalization。Results: Cardiac tumors and upper gastric tumors were 26 and 14 in the first group,and31 and 9 in the second group,respectively.Five patients in the first group and eight patients in the second group had a history of ulcers.The average operation time was270.48 ± 50.35 min in the first group and 266.30 ± 31.51 min in the secondgroup(P<0.05).The number of lymph nodes dissected during operation was 28.94 ±6.43 in the first group and 28.23 ± 7.91 in the second group(P>0.05).The average intraoperative blood loss was 192.91 ± 42.50 ml in the first group and 206.55 ± 33.72 ml in the second group(P<0.05).The average incision length and postoperative pain score of the first group were 4.20 ± 0.88 cm and 2.25 ± 0.53 points,respectively,and the second group were 8.14 ± 2.32 cm and 2.88 ± 0.34 points(P<0.05),respectively.In the first group,the time of the first postoperative anal exhaustion,the first postoperative fluid intake time,the first postoperative bedtime,and the postoperative hospital stay were 2.93 ± 0.75 days,4.82 ± 0.81 days,1.95 ± 0.32 days,9.14 ± 1.53,respectively.Days,the second group were 3.80 ± 0.85 days,5.91 ± 0.77 days,2.74 ± 0.27 days,10.12 ± 1.26 days(P<0.05).In terms of total hospitalization costs,the first group was6.12 ± 0.67 million,and the second group was 5.21 ± 0.54 million(P<0.05).In the early postoperative period,the first group suffered from 1 case of anastomotic leakage,2cases of anastomotic bleeding,and 1 case of postoperative pneumonia.No postoperative intestinal obstruction,anastomotic obstruction,incision infection,postoperative recurrence and other complications were found.The second Patients in the group found early anastomotic leakage in 2 cases,anastomotic bleeding in 3 cases,postoperative pneumonia in 2 cases,and incision infection in 1 case.No intestinal obstruction,anastomotic obstruction,and postoperative recurrence were found..Conclusion: TLTG has less postoperative pain than LATG.The time of getting out of bed,the time of first exhaustion after anus,the time of first meal after surgery,and the length of hospitalization after surgery are shorter.The time is short,the surgical incision is short,and the number of lymph node dissections is basically the same,but the total cost of hospitalization is higher.Therefore,TLTG is safer in clinical application,more effective,and it must be promoted.Appropriate treatment. |
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