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目的探讨腹腔镜辅助保留幽门胃切除术(LAPPG)在早期胃癌治疗中的安全性和可行性。方法回顾性分析上海交通大学医学院附属仁济医院胃肠外科2015年5月至2016年5月行LAPPG的24例早期胃体癌病人临床资料。结果 24例病人均成功实施LAPPG,无中转开放手术。手术时间(195.1±30.5)min,消化道重建时间(42.3±12.8)min,出血量(41.8±20.0)m L。术后排气时间(2.2±0.5)d,无严重手术相关并发症发生,术后中位住院时间为7 d。术后无病人出现严重营养不良,无病人出现严重餐后不适或胆汁反流性胃炎症状,中位随访时间4(1~12)个月,无病人发生肿瘤复发或死亡。结论对于肿瘤位于胃中1/3的早期胃体癌病人,LAPPG安全可行,有利于改善病人术后生活质量。
Objective To investigate the safety and feasibility of laparoscopic assisted retention pyloric gastrectomy (LAPPG) in the treatment of early gastric cancer. Methods The clinical data of 24 patients with early gastric cancer treated with LAPPG from May 2015 to May 2016 in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine were retrospectively analyzed. Results Twenty-four patients were successfully treated with LAPPG and no transit surgery. The operative time (195.1 ± 30.5) min, the time of digestive tract reconstruction (42.3 ± 12.8) min, the amount of bleeding (41.8 ± 20.0) m L Postoperative exhaust time (2.2 ± 0.5) d, no serious complications associated with surgery, postoperative median length of stay was 7 days. No postoperative patients with severe malnutrition, no patient with severe postprandial discomfort or bile reflux gastritis symptoms, the median follow-up time of 4 (1 ~ 12) months, no patient recurred or died of tumor. Conclusion LAPPG is safe and feasible for patients with early gastric cancer whose tumor is located in the stomach 1/3, which is beneficial to improve the postoperative quality of life of the patients.