Article(id=1198558108634149206, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198558106218230069, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.0384.2023.1229, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1678723200000, receivedDateStr=2023-03-14, revisedDate=null, revisedDateStr=null, acceptedDate=1692547200000, acceptedDateStr=2023-08-21, onlineDate=1763688121230, onlineDateStr=2025-11-21, pubDate=1727452800000, pubDateStr=2024-09-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1763688121230, onlineIssueDateStr=2025-11-21, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1763688121230, creator=13701087609, updateTime=1763688121230, updator=13701087609, issue=Issue{id=1198558106218230069, tenantId=1146029695717560320, journalId=1189873630562394117, year='2024', volume='49', issue='9', pageStart='977', pageEnd='1098', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1763688120655, creator=13701087609, updateTime=1763689155065, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1198562444915339352, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198558106218230069, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1198562444915339353, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198558106218230069, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1018, endPage=1021, ext={EN=ArticleExt(id=1198558109418484093, articleId=1198558108634149206, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Clinical efficacy of total laparoscopic proximal gastrectomy for cancer, columnId=1190310109000602400, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Clinical Research, runingTitle=null, highlight=null, articleAbstract=
Objective To analyze the clinical efficacy of total laparoscopic proximal gastrectomy and esophagogastric anastomosis to provide a new surgical method for the treatment of early proximal gastric cancer. Methods The clinical data of 80 patients with early gastric cancer who underwent proximal gastrectomy in the Department of General Surgery, the First Medical Center of Chinese PLA General Hospital from January 2019 to June 2021 were retrospectively analyzed. According to different surgical methods, the patients were divided into two groups: a total laparoscopic proximal gastrectomy group (n=36) and a laparoscopic-assisted proximal gastrectomy group (n=44). The perioperative conditions, long-term complications, and survival status were compared between the two groups. Results The length of surgical incision [(59.9±4.7) mm vs. (119.7±8.3) mm, P<0.001], first exhaust time [(58.2±15.3) h vs. (66.8±16.4) h, P=0.019] and postoperative hospital stay [(7.6±1.1) d vs. (9.2±1.3) d, P<0.001] of total laparoscopic proximal gastrectomy group were significantly shorter than those of laparoscope-assisted proximal gastrectomy group. The duration of operation [(186.9±16.4) min vs. (154.0±17.2) min, P<0.001] of total laparoscopic proximal gastrectomy group was significantly longer than that of laparoscopic-assisted proximal gastrectomy group. There were no significant differences in intra-operative hemorrhage, number of lymph nodedissection and first liquid diet feeding time between the two groups (P>0.05), and no early complications requiring surgical intervention occurred. The incidence of reflux esophagitis in the total laparoscopic proximal gastrectomy group was less than that in laparoscope-assisted proximal gastrectomy group [16.7%(6/36) vs. 38.6%(17/44), P=0.031]. There was no significant difference in gastric motility, residual gastritis, anastomosis stenosis and anastomotic ulcer between the two groups (P>0.05). Conclusion Total laparoscopic proximal gastrectomy and esophagogastric anastomosis have the characteristics of good safety, rapid postoperative recovery and anti-reflux, being worthy of clinical popularization.
, correspAuthors=Song-Yan Li, authorNote=null, correspAuthorsNote=
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目的 分析完全腹腔镜近端胃切除食管残胃吻合的临床疗效，为治疗早期近端胃癌提供新的手术方法。方法 回顾性分析2019年1月-2021年6月于解放军总医院第一医学中心普通外科医学部行近端胃切除术的80例早期胃癌患者的临床资料。根据手术方式不同分为完全腹腔镜近端胃癌切除术组(n=36)与腹腔镜辅助近端胃癌切除术组(n=44)。比较两组围手术期情况、远期并发症发生情况及生存状况。结果 完全腹腔镜近端胃癌切除术组腹部切口长度[(59.9±4.7) mm vs. (119.7±8.3) mm，P<0.001]、首次排气时间[(58.2±15.3) h vs.(66.8±16.4) h，P=0.019]及术后住院时间[(7.6±1.1) d vs. (9.2±1.3) d，P<0.001]均短于腹腔镜辅助近端胃癌切除术组，手术时间[(186.9±16.4) min vs. (154.0±17.2) min，P<0.001]长于腹腔镜辅助近端胃癌切除术组。两组术中出血量、淋巴结清扫数目和首次进流食时间差异无统计学意义(P>0.05)，且均未发生需外科干预的早期并发症。随访期间两组无患者死亡，未出现复发或转移。完全腹腔镜近端胃癌切除术组反流性食管炎发生率低于腹腔镜辅助近端胃癌切除术组，差异有统计学意义[16.7%(6/36) vs. 38.6%(17/44)，P=0.031]。两组胃动力不足、残胃炎、吻合口狭窄、吻合口溃疡发生率差异无统计学意义(P>0.05)。结论 完全腹腔镜近端胃切除食管残胃吻合具有安全性好、术后恢复快、抗反流等特点，值得临床应用推广。
, correspAuthors=李松岩, authorNote=null, correspAuthorsNote=
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刘帛岩，硕士研究生，主要从事胃肠道肿瘤治疗方面的研究
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Main operation procedure and postoperative digestive tract radiography of total laparoscopic proximal gastrectomy, figureFileSmall=7WHLrx8pTUqe0HXI/PNYkQ==, figureFileBig=MI3Vj074WL0EF1QLzeWsog==, tableContent=null), ArticleFig(id=1198558113772171823, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558108634149206, language=CN, label=图1, caption=
完全腹腔镜近端胃癌切除术主要手术步骤及术后消化道造影A. 离断食管；B. 食管残胃吻合；C. 关闭共同开口；D. 术后消化道造影
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Comparison of general data between two groups of patients with gastric cancer
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| 项目 | 完全腹腔镜近端胃癌切除术组(n=36) | 腹腔镜辅助近端胃癌切除术组(n=44) | t/χ2 | P |
|---|
| 年龄(岁, $\bar{x}±s$) | 56.5±6.9 | 54.7±5.1 | 1.269 | 0.209 |
| 性别[例(%)] | | | | |
| 男 | 21(58.3) | 26(59.1) | 0.005 | 0.945 |
| 女 | 15(41.7) | 18(40.9) | | |
| BMI(kg/m2, $\bar{x}±s$) | 24.2±1.2 | 24.6±1.2 | -1.601 | 0.113 |
| ASA分级[例(%)] | | | 0.357 | 0.550 |
| Ⅰ-Ⅱ | 34(94.4) | 40(90.9) | | |
| Ⅲ-Ⅳ | 2(5.6) | 4(9.1) | | |
| 腹部手术史[例(%)] | | | 0.202 | 0.653 |
| 有 | 3(8.3) | 5(11.4) | | |
| 无 | 33(91.7) | 39(88.6) | | |
), ArticleFig(id=1198558115156292158, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558108634149206, language=CN, label=表1, caption=
两组胃癌患者一般资料比较
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| 项目 | 完全腹腔镜近端胃癌切除术组(n=36) | 腹腔镜辅助近端胃癌切除术组(n=44) | t/χ2 | P |
|---|
| 年龄(岁, $\bar{x}±s$) | 56.5±6.9 | 54.7±5.1 | 1.269 | 0.209 |
| 性别[例(%)] | | | | |
| 男 | 21(58.3) | 26(59.1) | 0.005 | 0.945 |
| 女 | 15(41.7) | 18(40.9) | | |
| BMI(kg/m2, $\bar{x}±s$) | 24.2±1.2 | 24.6±1.2 | -1.601 | 0.113 |
| ASA分级[例(%)] | | | 0.357 | 0.550 |
| Ⅰ-Ⅱ | 34(94.4) | 40(90.9) | | |
| Ⅲ-Ⅳ | 2(5.6) | 4(9.1) | | |
| 腹部手术史[例(%)] | | | 0.202 | 0.653 |
| 有 | 3(8.3) | 5(11.4) | | |
| 无 | 33(91.7) | 39(88.6) | | |
), ArticleFig(id=1198558115349230147, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558108634149206, language=EN, label=Tab.2, caption=
Comparison of perioperative indicators between two groups of patients with gastric cancer ($\bar{x}±s$)
, figureFileSmall=null, figureFileBig=null, tableContent=
| 指标 | 完全腹腔镜近端胃癌切除术组(n=36) | 腹腔镜辅助近端胃癌切除术组(n=44) | t/Z | P |
|---|
| 手术时间(min) | 186.9±16.4 | 154.0±17.2 | 8.689 | <0.001 |
| 术中出血量(ml) | 39.5±7.6 | 38.8±8.2 | 0.395 | 0.694 |
| 腹部切口长度(mm) | 59.9±4.7 | 119.7±8.3 | -40.381 | <0.001 |
| 淋巴结清扫数目(个) | 21.1±3.5 | 22.1±4.2 | -1.174 | 0.244 |
| 首次排气时间(h) | 58.2±15.3 | 66.8±16.4 | -2.400 | 0.019 |
| 首次进流食时间(h) | 102.1±8.5 | 104.7±9.0 | -1.347 | 0.182 |
| 术后住院时间(d) | 7.6±1.1 | 9.2±1.3 | -5.088 | <0.001 |
), ArticleFig(id=1198558115491836488, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558108634149206, language=CN, label=表2, caption=
两组胃癌患者围手术期指标比较($\bar{x}±s$)
, figureFileSmall=null, figureFileBig=null, tableContent=
| 指标 | 完全腹腔镜近端胃癌切除术组(n=36) | 腹腔镜辅助近端胃癌切除术组(n=44) | t/Z | P |
|---|
| 手术时间(min) | 186.9±16.4 | 154.0±17.2 | 8.689 | <0.001 |
| 术中出血量(ml) | 39.5±7.6 | 38.8±8.2 | 0.395 | 0.694 |
| 腹部切口长度(mm) | 59.9±4.7 | 119.7±8.3 | -40.381 | <0.001 |
| 淋巴结清扫数目(个) | 21.1±3.5 | 22.1±4.2 | -1.174 | 0.244 |
| 首次排气时间(h) | 58.2±15.3 | 66.8±16.4 | -2.400 | 0.019 |
| 首次进流食时间(h) | 102.1±8.5 | 104.7±9.0 | -1.347 | 0.182 |
| 术后住院时间(d) | 7.6±1.1 | 9.2±1.3 | -5.088 | <0.001 |
), ArticleFig(id=1198558115613471310, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558108634149206, language=EN, label=Tab.3, caption=
Comparison of incidence of postoperative long-term complications between two groups of patients with gastric cancer [n(%)]
, figureFileSmall=null, figureFileBig=null, tableContent=
| 并发症 | 完全腹腔镜近端胃癌切除术组(n=36) | 腹腔镜辅助近端胃癌切除术组(n=44) | χ2 | P |
|---|
| 反流性食管炎 | 6(16.7) | 17(38.6) | 4.665 | 0.031 |
| 胃动力不足 | 7(19.4) | 11(25.0) | 0.350 | 0.554 |
| 残胃炎 | 13(36.1) | 20(45.5) | 0.713 | 0.398 |
| 吻合口狭窄 | 2(5.6) | 6(13.6) | 1.437 | 0.231 |
| 吻合口溃疡 | 5(13.9) | 8(18.2) | 0.268 | 0.605 |
), ArticleFig(id=1198558115747689042, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558108634149206, language=CN, label=表3, caption=
两组胃癌患者术后远期并发症发生率比较[例(%)]
, figureFileSmall=null, figureFileBig=null, tableContent=
| 并发症 | 完全腹腔镜近端胃癌切除术组(n=36) | 腹腔镜辅助近端胃癌切除术组(n=44) | χ2 | P |
|---|
| 反流性食管炎 | 6(16.7) | 17(38.6) | 4.665 | 0.031 |
| 胃动力不足 | 7(19.4) | 11(25.0) | 0.350 | 0.554 |
| 残胃炎 | 13(36.1) | 20(45.5) | 0.713 | 0.398 |
| 吻合口狭窄 | 2(5.6) | 6(13.6) | 1.437 | 0.231 |
| 吻合口溃疡 | 5(13.9) | 8(18.2) | 0.268 | 0.605 |
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