Analysis Of Short-term Clinical Effect Of Total Laparoscopic-assisted Radical Gastrectomy For Gastric Cancer

Purpose:Compare and anaiyze the short-term clinical effect of totally laparoscopic-assisted and laparoscopic-assisted radical gastrectomyfor gastric cancer,and to evaluate the safety and feasibility between the two methods.Method:To anaiyze the clinical data of 214 patients（60 patients in the complete laparoscopic-assisted group and 154 patients in the laparoscopic-assisted group）who met the inclusion criteria from September 2019 to September 2021 in the Department of Gastroenterology,colorectal and anal surgery of Jilin University China Japan Union Hospital,general information such as sex,age,BMI,and other medical history were compared between the two groups;Introperative data were compared between the two groups,for example,the operative time,the amount of bleeding during operation,incision length and number of lymph node dissection;Post-operative complication were compared between the two groups,for example,anastomotic fistulas,anastomotic bleeding,bleeding from duodenum stump,duodenum fistula,anastomotic stenosis,postoperative intestinal obstruction,incision infection,incidence of delayed anastomotic clearance;Post-operative general condition were compared between the two groups,including postoperative analgesic dosage,postoperative exhaust time,postoperative feeding time,total hoapital costs,total hospital time and other indicators.SPSS26.0 software was used for statistical analysis to explore the difference between the two methods of clinical effects.Result:1、In comparison with the general data of sex,age,BMI,history of hypertension,history of somking and drinking,tumber location and tumber staging between the two groups,the differences were not statistically significant（P>0.05）.2、The intraoperative and postoperative data of the two groups were analyzed.The time of total laparoscopic-assisted radical gastrectomy for gastric cancer was（247.5±52.38）min,and the time for laparoscopic-assisted radical gastrectomy for gastric cancer was（229.13±43.2）min;For the statistics on the amount of blood loss,the total laparoscopic-assisted radical gastrectomy for gastric cancer was（98.75±32.38）ml,and the statistics on the amount of blood loss for the laparoscopic-assisted radical gastrectomy for gastric cancer was(120±59.17ml;For the incision length,the total laparoscopic-assisted radical gastrectomy for gastric cancer was（5.04±1.24）cm,and the incision length for the laparoscopic-assisted radical gastrectomy for gastric cancer was（7.76±1.98）cm;The delayed rate of anastomotic emptying in the total laparoscopic-assisted radical gastrectomy for gastric cancer groups was8.33%,and the rate in the laparoscopic-assisted radical gastrectomy for gastric cancer groups was 25.97%;The anus exaust time of the total laparoscopic-assisted radical gastrectomy for gastric cancer was（2.73±0.94）d,and the time for the laparoscopic-assisted radical gastrectomy for gastric cancer was（3.29±1.17）d;The postoperative feeding time of the total laparoscopic-assisted radical gastrectomy for gastric cancer was（3.43±0.99）d,and the time for the laparoscopic-assisted radical gastrectomy for gastric cancer was（3.98±1.16）d;The dosage of poseoperative analgesia in total laparoscopic-assisted radical gastrectomy for gastric cancer group was（195.83±125.65）mg,and the dosage for laparoscopic-assisted radical gastrectomy for gastric cancer group was（297.73±104.37）mg;The total hospitalization expenses of total laparoscopic-assisted radical gastrectomy for gastric cancer group were（100.65±17.7）thousand yuan,and the expenses of laparoscopic-assisted radical gastrectomy for gastric cancer group were（90.8±18.1）thousand yuan;The total length of hospital stays in total laparoscopic-assisted radical gastrectomy for gastric cancer was（16.78±7.58）d,and the laparoscopic-assisted radical gastrectomy for gastric cancer group was（20.47±7.58）d.The two groups in the above observation index statistical analysis,the difference was ststistically significant（P<0.05）.3 、 There was no statistically significant in the incidence of total complications between the total laparoscopic-assisted and laparoscopic-assisted radical gastrectomy（there were no statistically differences in anastomotic leakage,anastomotic bleeding,anastomotic stenosis,bleeding from duodenum stump,duodenum fistula,postoperative intestinal obstruction and wound infection）.the number of lymph nodes cleared in the two groups was not statistically significant（P>0.05）.Conclusion:1.Totally laparoscopic-assisted radical gastrectomy for gastric cancer is recommend.2.Totally laparoscopic-assisted radical gastrectomy for gastric cancer has the advantages of less trauma,less postoperative pain,shorter incision scar,faster postoperative recovery,short hospital stay and so on.3.There was no additional increase in total postoperative complications after total laparoscopic-assisted radical gastrectomy for gastric cancer.4.Totally laparoscopic-assisted radical gastrectomy for gastric cancer is associated with a low incidence of delayed stoma emptying.5.Total laparoscopic-assisted radical gastrectomy is more expensive.