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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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Objectives:To analyze the clinical value and safety of total laparoscopic gastro-duodenal triangle anastomosis in radical surgery of distal gastric cancer.Methods:Sixty patients with gastric cancer treated from May 2013 to August 2016 were selected as study subjects and randomly divided into experimental group and control group,with 30 cases in each group.The experimental group was given laparoscopic radical gastrectomy for gastro-duodenal anastomosis,while the control group was given laparoscopic auxiliary distal gastrectomy for radical gastrectomy.The clinical efficacy and safety of the two groups were compared.Results:Compared with the control group,the operation time of the experimental group was longer,the blood loss was less,the distal margin of the tumor was longer,the postoperative pain score was lower and the dosage of analgesics was less (P＜0.05);There was no significant difference in TNM stage and Lauren classification between the two groups(P＞0.05).The incidence of postoperative complications in the experimental group was 6.67％,which was lower than that in the control group(10.0％),but the difference was no Statistical significance (P＞0.05).Conclusion:Total laparoscopic distal gastric cancer Gastro-duodenal triangle anastomosis is effective and safe,and worthy of clinical application.
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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.