腹腔镜远端胃切除术与保留幽门胃切除术治疗早期胃癌的疗效对比研究OACSTPCD

Objective:To compare the effectiveness and safety of laparoscopic distal gastrectomy(LDG)and laparoscopic pylo-rus preserving gastrectomy(LPPG)in the treatment of early gastric cancer.Methods:From Mar.2018 to Mar.2022,108 patients with early gastric cancer were selected and divided into two groups based on different surgical treatments:68 patients underwent LDG(LDG group)and 40 patients underwent LPPG(LPPG group).The surgical outcomes,postoperative recovery,postoperative complications incidence and hospitalization expenses were compared between two groups.Results:There were no significant differences in surgical time,intraoperative blood loss,number of lymph node dissected,postoperative recovery time(first exhaust,first defecation,first diet,drainage tube removal,gastric tube removal,hospital stay)between the two groups(P>0.05).The distance to distant incision margin of the tumor in LPPG group was significantly shorter than that in LDG group(P<0.05).The total hospitalization expenses of LPPG group were lower than those of LDG group(P<0.05).The incidence of delayed gastric emptying in LDG group was lower than that in LPPG group(7.35％vs.30.00％,P<0.05),and the incidence of acid reflux was higher than that in LPPG group(20.59％vs.0,P<0.05).The postoperative complications total incidence of LDG group and LPPG group was similar(32.35％vs.35.00％,P>0.05).Compared with LDG group,the incidence of secondary bile reflux gastritis in LPPG group was lower in 1 year after surgery,and the inci-dence of grade Ⅱ to Ⅲ bile reflux gastritis was also lower(P<0.05).The 3-year survival rate between the LDG group and LPPG group was not significantly different(80.88％vs.80.00％,P>0.05).Conclusions:In the clinical treatment of early gastric cancer,both LPPG and LDG have good effects,but the former is more helpful in reducing postoperative acid reflux and secondary bile reflux gastritis,with lower treatment costs.