脐上或脐下观察孔在腹腔镜远端胃癌根治性切除术中的选择OACSTPCD

Objective:To compare the clinical effects of supraumbilical and subumbilical observation port positions in laparo-scopic radical gastrectomy for distal gastric cancer.Methods:The clinical data of 71 patients who underwent laparoscopic distal gastrec-tomy for gastric cancer from Jan.2021 to Oct.2023 were retrospectively analyzed.According to the location of the observation port du-ring operation,the patients were divided into two groups:supraumbilical group(n=37)and subumbilical group(n=34).The time from skin incision to lymph node dissection,intraoperative blood loss,number of lymph node dissection,incidence of early postoperative com-plications and postoperative hospital stay were compared between the two groups.Both groups,operations were performed by the same physician team.Results:The surgery was successfully completed in both groups,and there was no conversion to open operation or seri-ous intraoperative complications.The time from skin incision to lymph node dissection in the supraumbilical group was shorter than that in the subumbilical group[(118.8±5.2)min vs.(140.6±8.4)min,P<0.05].The intraoperative blood loss in the supraumbilical group was significantly less than that in the subumbilical group[(29.7±6.2)mL vs.(32.7±5.5)mL,P<0.05].The number of lymph node dissection in the supraumbilical group was significantly higher than that in the subumbilical group[(35.4±5.2)vs.(32.7±5.5),P<0.05].There was no significant difference in postoperative hospital stay[(6.7±1.2)d vs.(6.8±1.3)d,P>0.05]and total incidence of complications[10.8%(4/37)vs.14.7%(5/34)]between the two groups.Conclusions:The selection of supraumbilical observation port in laparoscopic distal gastrectomy for gastric cancer has better surgical field,easier exposure of the left and right area at upper edge of the pancreas,and has more advantages in the lymph node excision of the left and right area at upper edge of the pancreas,and the surgical effect is better.