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Objective:To evaluate the safety and feasibility of enhanced recovery after surgery (ERAS) in total laparoscopic Uncut Roux-en-Y gastrojejunostomy after distal gastrectomy.Methods:The clinical data of 42 patients who were divided into ERAS group (n=20) and control group (n=22) were collected.Observation indicators included operation condition,postoperative clinical indexes and postoperative serum stress indexes.Measurement data with normal distribution were presented as-x±s and analyzed by T test.Count data were analyzed by the chi-square test.Results:The operative time,volume of intraoperative blood loss and number of patients with conversion to open surgery shown no statistically significant difference between the 2 groups(P＞0.05).Postoperative clinical indexes:time for initial anus exhaust,time for initial liquid diet intake,time for out-of-bed activity,duration of hoSpital stay of patients without complications in the ERAS group were lower than in the control group,with statistically significant differences between the 2 groups (P＜0.05).But the time to initial defecation,time of abdominal drainage-tube removal and the early postoperative complications between the 2 group had no statistically difference(P＞0.05). Postoperative complications:at the first days and the third days after operation,WBC,CRP and I L-6 in ERAS group were lower than in the control group,the differences were statistically significant (P＜0.05).Conclusion:The perioperative ERAS program in total laparoscopic Uncut Roux-en-Y gastrojejunostomy after distal gastrectomy is safe and effective and should be popularized,meanwhile,it can also reduce duration of hospital stay and improve the comfortable degree and satisfaction of patients.
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Objective To evaluate the effect of Dachengqi decoction,omeprazole and cisapride in the treatment of gastric cancer radical operation in serum gastrin and motilin.Methods 88 cases of gastric cancer after radical gastrectomy from May 2013 to July 2015 in our hospital were selected and divided into control group and treatment group with each 44 cases.Patients in both groups were given routine treatment and symptomatic treatment.Control group received omeprazole Enteric-coated capsules 20mg,qd,cisapride tablets 10mg,tid,treatment group received more Dachengqi decoction 200mL,bid,respectively by intragastric injection and retention enema,two times a day,a total of 21 days of treatment.The clinical efficacy,serumgastrin,plasma gastric motility,gastric juice volume and adverse reactions were compared between the two groups.Results The total effective rate in the treatment group was significantly higher than that in control group(P<0.05); After treatment,gastric juice volume of two groups was significantly lower than before treatment,the gastric juice volume in the treatment group were significantly lower than control group(P<0.05);Compare with pre-treatment,after treatment,the serum gastrin,plasma gastric motility levels of two groups were significantly higher,and the treatment group were significantly higher than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Omeprazole,cisapride combined with Dachengqi decoction in the treatment of gastric cancer radical operation was obvious and high safety.
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Objective To evaluate the safety,tumor radical and early postoperative efficacy through comparison of laparoscopic gastric D2 radical surgery with traditional open gastric D2 radical surgery.Methods 254 patients with upper stomach cancer underwent surgery were selected,132 cases using conventional open gastrectomy (the traditional laparotomy group),122 patients underwent laparoscopic radical gastrectomy (laparoscopic surgery group).Laparoscopic surgery group with traditional open surgery group had no statistically significant differences in gender,age,tumor location,histological type and TNM staging.Results Open surgery group and laparoscopic surgery group had statistically significant differences in operative time [(235.78±31.56) min,(256.43±54.08) min,P ＜ 0.001],blood loss [(326.69±89.73) ml,(158.31±62.98) ml,P ＜ 0.001],incision length [(16.53±2.34) cm,(5.51±1.15) cm,P ＜ 0.001],gastrointestinal recovery time [(4.22±0.91) d,(3.31±0.83) d,P ＜ 0.001],first time eating liquid [(5.78±0.95) d,(5.56±0.78) d,P ＜ 0.001] and postoperative hospital stay [(12.62±2.89) d,(11.18±1.78) d,P ＜ 0.001].The total number of lymph node dissection and complications was not statistically significant.Conclusions Laparoscopic gastric D2 radical surgery is a safe,minimally invasive surgical method.Laparoscopic gastric D2 radical surgery has the same lymph node dissection and good early outcome compared with the traditional gastric D2 radical surgery,but postoperative recovery fast and less invasive.
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Objective To compare the effect of laparoscopic-assisted and open distal gastric cancer radical operation for advanced gastric cancer and evaluate the feasibility and short-term outcomes of laparoscopic-assisted distal gastric cancer radical operation.Methods The clinical data of 198 patients from January 2007 to December 2011 were analyzed retrospectively.Ninety-one patients who underwent laparoscopic-assisted distal gastric cancer radical operation was in laparoscopy group,and 107 patients who underwent open distal gastric cancer radical operation was in open operation group.Results The operative time in laparoscopy group was significantly longer than that in open operation group [(260.08 ± 26.28) min vs.(231.74 ± 17.33) min],and intraoperative blood loss volume,incision length,recovery of bowel activity,time of stay in hospital and recovery eating were significantly shorter than those in open operation group [(152.13 ± 51.05) nl vs.(348.00 ± 110.36) ml,(5.02 ± 0.82) cm vs.(19.13 ± 1.57) cm,(2.79 ± 0.75) d vs.(4.49 ± 1.09) d,(9.97 ± 2.08) d vs.(12.15 ± 2.46)d,(6.91 ± 1.44) d vs.(7.45 ± 1.08) d,P＜ 0.05].The total number of lymph nodes and postoperative complication had no significant difference between two groups (P ＞ 0.05).Conclusions The laparoscopic-assisted distal gastric cancer radical operation for advanced gastric cancer is safe and feasible.It has better short-term outcomes.