中国现代手术学杂志2025，Vol.29Issue(2)：106-113,8.DOI:10.16260/j.cnki.1009-2188.2025.02.004
单孔加一孔(SILS+1)技术在全腹腔镜胃癌根治术中的应用
Clinical application of single-incision plus one-port laparoscopic surgery(SILS+1)in total laparoscopic radical gastrectomy for gastric cancer
摘要
Abstract
Objective To evaluate the clinical efficacy,safety,and feasibility of the single-incision plus one-port laparoscopic surgery(SILS+1)for totally laparoscopic radical gastrectomy in gastric cancer patients.Methods A retrospective study was conducted on 142 gastric cancer patients who underwent totally laparoscopic radical gastrectomy in our hospital between January 2020 and January 2021.According to the sur-gical approach,patients were divided into two groups:The SILS+1 group(n=67)underwent totally laparoscopic radical gastrectomy with the SILS+1 technique,and the conventional group(n=75)underwent totally laparo-scopic radical gastrectomy with the traditional five-port technique.Perioperative outcomes,postoperative complications,inflammatory biomarkers,as well as 3-year overall survival and 3-year disease-free survival were compared between the two groups.Results Compared to the conventional group,the SILS+1 group demonstrated significantly less intraoperative blood loss,shorter total incision length,lower 24-hour postopera-tive NRS pain scores,faster time to first flatus,and shorter postoperative hospital stay(all P＜0.05).There were no statistically significant differences in operative time,time to first ambulation,time to first oral intake,number of lymph nodes dissection,or postoperative complication rate between the two groups(all P＞0.05).On postoperative day 1,all inflammatory markers(WBC,CRP,PCT,IL-6)showed significant elevation from preoperative levels in both groups(all P＜0.05),with significantly lower increases in the SILS+1 group versus the conventional group(all P＜0.05).With a median follow-up of 38 months(IQR:19～50 months),there were no significant differences in the 3-year overall survival rate(76.90％vs.80.23％,P＞0.05)or the 3-year disease-free survival rate(70.20％vs.65.23％,P＞0.05)between the two groups.Conclusions The SILS+1 technique is safe and feasible in totally laparoscopic radical gastrectomy for gastric cancer.This procedure significantly reduces surgical trauma,alleviates postoperative pain,accelerates recovery,and effectively attenuates early postoperative inflammatory responses.Most importantly,it ensures thorough lymph node dissection while preserving patients'long-term survival benefits.For surgeons with proficient laparoscopic skills and substantial experience,the SILS+1 technique represents an optimized minimally invasive strategy worthy of clinical application.关键词
胃癌/腹腔镜胃癌根治术/单孔加一孔技术Key words
gastric cancer/laparoscopic radical gastrectomy for gastric cancer/single-incision plus one-port laparoscopic surgery(SILS+1)引用本文复制引用
李坤,许威,赵丽君..单孔加一孔(SILS+1)技术在全腹腔镜胃癌根治术中的应用[J].中国现代手术学杂志,2025,29(2):106-113,8.基金项目
甘肃省青年科技基金(22JR11RA002) （22JR11RA002）
