The Safety Of Single Incision Plus One Trocar(SPOT)laparoscopic Total Gastrectomy For Gastric Cancer

Objective:To investigate the clinical safety of single incision plus one trocar(SPOT)laparoscopic total gastrectomy for gastric cancer.Methods:The clinical data of 240 patients with gastric cancer undergoing laparoscopic total gastric resection from January 2016 to April 2020 in the affiliated Hospital of Qinghai University were analyzed retrospectively,including 54 patients in the traditional group(5-incision method).55 cases were improved single incision group(2-incision method).The operative data(time of operation,time of lymph node dissection,time of reconstruction of digestive tract,amount of bleeding during operation),postoperative data(time of getting out of bed,postoperative VAS score,postoperative exhaust time,diet time,time of drainage tube extraction,days of hospitalization after operation),postoperative laboratory data(leukocyte count,neutrophil count,serum albumin,serum procalcitonin,serum c reactive protein,lymphocyte count,hemoglobin,platelet count,serum total bilirubin,serum alkaline enzyme),postoperative pathological results(Borrmann’s typing,tumor differentiation,Lauren’s typing,nerve invasion,vascular invasion),surgical radical indexes(total number of lymph nodes cleaned,number of lymph nodes positive,distance of tumor from oral and anal margin),postoperative complications(anastomotic fistula,anastomotic bleeding,abdominal infection,wound-related complications,intestinal obstruction,pulmonary infection,pancreatic fistula).Results:Surgical data(operative time,lymph node dissection time,intraoperative blood loss),postoperative data(postoperative 5 days vas score,postoperative feeding time,drainage tube extraction time),postoperative laboratory data(leukocyte count,neutrophil count,serum albumin,lymphocyte count,hemoglobin,platelet count,serum total bilirubin,serum alkaline phosphatase),postoperative pathological results(Borrmann typing,tumor differentiation,Lauren typing,nerve invasion,vascular invasion),surgical radical index(total lymph node dissection,lymph node count)were used in both groups There was no significant difference in the number of positive junction,the distance between tumor and anal margin,postoperative complications(anastomotic leakage,anastomotic bleeding,abdominal infection,intestinal obstruction,pulmonary infection,pancreatic fistula)(p value >0.05);There were significant differences in digestive tract reconstruction time,postoperative time to get out of bed,postoperative exhaust time,postoperative hospitalization days,VAS score of the first and third days after operation,serum procalcitonin on the first day after operation,reactive protein content c the first and third days after operation and incision related complications(p value ≤0.05).Conclusion:Single incision plus one trocar(SPOT)laparoscopic total gastrectomy for gastric cancer is safe and feasible and can be used as one of the options for surgical treatment of gastric cancer.