A comparative study of short-term clinical outcomes of total laparoscopic and laparoscopic- assisted radical resection of distal gastric cancer: a propensity score-matched analysis
10.3760/cma.j.cn113855-20230331-00166
- VernacularTitle:全腹腔镜和腹腔镜辅助远端胃癌根治术短期疗效的对比研究
- Author:
Shenxiang LONG
1
;
Xinning WANG
;
Xubin WANG
;
Xuehui MAO
;
Shubo TIAN
;
Leping LI
;
Xiaobo GUO
Author Information
1. 山东第一医科大学附属省立医院胃肠外科，济南 250021
- Keywords:
Stomach neoplasms;
Gastrectomy;
Laparoscopy
- From:
Chinese Journal of General Surgery
2024;39(2):86-91
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the short-term clinical outcomes of total laparoscopic distal gastrectomy (TLDG) and laparoscopic-assisted distal gastrectomy (LADG) combined with Billroth-Ⅱ+Braun anastomosis.Methods:Clinical characteristics of patients undergoing laparoscopic distal gastrectomy combined with Billroth-Ⅱ+Braun anastomosis at Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University from Jan 2020 to Oct 2022 were analyzed. Patients were divided into TLDG group ( n=62) and LADG group ( n=62) according to the surgical approach. Results:There were significant differences in the preoperative clinical data section between the two groups, and 124 patients (62 in each group) were enrolled after using propensity score matching to balance significant variables. Compared with the LADG group, the TLDG group showed statistically differences in time to first venting [(2.9±1.3) vs. (2.3±0.8) d, Z=-3.072, P=0.002], time to first fluid diet [(5.9±1.3) vs. (5.4±1.4) d, Z=-2.031, P=0.042] and incision length [(7.1±1.4) vs. (4.8±0.8) cm, Z=-6.331, P=0.000]. Total postoperative complication rate in the TLDG group and the LADG group (29% vs. 37%, χ2=0.911, P=0.340) was not statistically significant. Incidence of postoperative pneumonia was lower in the TLDG group than in the LADG group (3% vs. 13%, χ2=3.916, P=0.048), and incidence of all remaining postoperative complications were not statistically significant. There was no statistically significant difference in the incidence of serious postoperative complications between the TLDG and LADG groups ( P=1.000). Multifactorial analysis revealed that male ( P=0.023) and age ≥65 years ( P=0.001) were independent risk factors for postoperative complications. Conclusion:TLDG is safe and feasible and has better short-term clinical efficacy than LADG.
