| Objective:A retrospective analysis of LAPPG and LADG from the perspective of postoperative perioperative outcome and nutritional status and complications in one year after surgery.Methods:A total of 101 patients with early middle and lower gastric cancer from Jan.2015 to Dec.2019 were collected retrospectively in our hospital.Among them,49 patients underwent LAPPG surgery and 52 patients underwent LADG surgery.They were divided into LAPPG group and LADG group.In the LAPPG group,LN dissection was performed in the D1+8a,9,and 11p groups,and manual gastrogastric anastomosis was used to complete the digestive tract reconstruction;in the LADG group,D2 LN dissection was performed in all groups,and B-II+Braun digestive tract reconstruction was performed in all cases;the case data included clear patients Information,including gender,age,preoperative BMI,preoperative ASA score,operation method,operation time,intraoperative blood loss,tumor size,far and near resection margins,LN status,tissue type,degree of invasion,degree of differentiation,length of stay,operation Postoperative pathology,etc.;Postoperative patients are regularly reviewed in the outpatient clinic.Using SPSS23.0 statistical software to process the experimental data,P value less than 0.05 is considered to be statistically different.The t test,the Mann-Whitney rank sum test and the chi-square test(or Fisher’s exact test)were used to analyze the normal distribution of measurement data,non-normal distribution measurement data and classification data in the perioperative outcome;The t test analyzes the serum total albumin level,serum albumin level,hemoglobin level and body mass index level of the patients 1 year after surgery;The Clavien-Dindo classification system was used to categorize the complications of patients within 1 month after the operation,and further compare the short-term postoperative complications of the two groups with chi-square test;Collect the data of gastroscopy,abdominal CT and abdominal color Doppler ultrasound one year after the operation,and analyze whether there are statistical differences in the prevalence of gastric retention,bile reflux,and gallbladder stones in the LAPPG group and the LADG group one year after the operation.Results:1.The comparison between the two groups of patients in terms of surgery:the LAPPG group and the LADG group had statistical differences in the average distance of the distal resection margin and the average number of lymph nodes harvested during the operation(P<0.05).2.Comparison of postoperative nutritional status of the two groups of patients:After 1 year follow-up,there were statistical differences in serum total protein levels,serum albumin levels,hemoglobin levels,and body mass index between the LAPPG group and the LADG group(P<0.05).3.Comparison of complications between the two groups of patients within one month after surgery:Compare the LAPPG group and the LADG group,no statistical difference in the overall prevalence of early complications,and no statistical difference in the severity of the Clavien-Dindo classification.4.Comparison of 1 year postoperative complications between the two groups:After 1 year of follow-up,a statistical difference in the prevalence of gastric retention 1 year after the LAPPG group and the LADG group(p<0.05).The prevalence of gastric retention in the LAPPG group(10 cases,20.4%)was higher than that in the LADG group(3 cases,5.8%);A statistical difference in the prevalence of bile reflux 1 year after operation between the LAPPG group and the LADG group(p<0.05).The prevalence of bile reflux in the LAPPG group(3 cases,6.1%)was lower than that in the LADG group(11 cases,21.2%);The prevalence of gallbladder stones in the LAPPG group was significantly different from that in the LADG group at 1 year after surgery(p<0.05),and the prevalence of gallbladder stones in the LAPPG group(1 case,2.0%)was lower than that in the LADG group(8 cases,15.4%)Conclusions:1.The distance to the distal resection edge of the LAPPG group(3.47±0.63cm)is less than the distance to the distal resection edge of the LADG group(4.32±0.60cm).The mean of lymph nodes harvested in the LAPPG group(19.90±9.69 pieces)is less than the mean of lymph nodes harvested in the LADG group(24.46±10.26 pieces);2.Compared with the LADG group,the LAPPG group has significantly improved serum total protein levels,serum albumin levels,hemoglobin levels,and body mass index,and has more nutritional advantages;3.No matter whether it is LAPPG or LADG surgery,it has no differences on the occurrence of short-term complications after the patient’s operation;4.After 1 year of follow-up,the prevalence of gastric retention one year after LADG is lower than that of LAPPG;the prevalence of bile reflux and gallbladder stones in the LAPPG group was lower than that in the LADG group at 1 year;... |
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