Application Value Of Duodenal Priority Dissection In Laparoscopic Assisted Radical Distal Gastrectomy

Objective:To explore the short-term efficacy and long-term prognosis of laparoscopic assisted distal gastrectomy for duodenal priority dissection,in order to provide reference for the choice of surgical methods for laparoscopic radical gastrectomy.Methods:The general clinical data of 98 patients with gastric cancer admitted to our hospital from October 2016 to October 2017 were collected.According to the different surgical approaches,the two groups were divided into two groups,the observation group was the duodenum preferential dissection,and the control group was the left posterior approach.The operation time,intraoperative blood loss,lymph node dissection,first ventilation time,and hospitalization time were analyzed and compared between the two groups.The comparison between the two groups of patients with preoperative and postoperative 1,3,and 5 postoperative inflammatory markers CRP and WBC levels Differences and trends;analysis and comparison of postoperative complications in the two groups;analysis of the two-year survival rate of the two groups.Results:The operation time of the observation group was lower than that of the control group.There was significant difference between the two groups(P<0.01).The intraoperative blood loss of the observation group was lower than that of the control group.There was significant difference between the two groups(P<0.01).There was no statistical difference in the number of lymph node dissections between the two groups(P>0.05).The first ventilation time and hospitalization days were lower in the observation group than in the control group.There was statistical difference between the two groups(P<0.05).There was no significant difference in the preoperative CRP and WBC levels between the two groups(P>0.05).The CRP value of the observation group was lower than that of the control group on the first day after operation.There was significant difference between the two groups(P<0.01).The WBC level of the observation group was lower than that of the control group on the 1st day after operation.There was significant difference between the two groups(P<0.01).There was no statistical comparison between CRP and WBC levels on the 3rd and 5th day after operation.Learning differences(P>0.05).The incidence of postoperative complications in the two groups(2/50,4.0%vs 3/48,6.3%,?~2=0.256,P=0.613),there was no statistical difference in the comparison between the groups.The survival rate of the two groups after radical gastrectomy(40/50,80.0%vs 39/48,81.3%,Log-rank?~2=0.004,P=0.947),there was no statistical difference in the survival rate between the two groups.Conclusions:Duodenal priority dissection can simplify the surgical procedure of laparoscopic assisted distal gastrectomy for gastric cancer,less operation time and intraoperative blood loss,reduce systemic inflammatory response caused by surgery,and increase postoperative complications.The incidence does not affect patient survival.The recent advantages of duodenal priority dissection are obvious,and there is no obvious adverse effect in the long-term.The surgical effect is certain and it is worthy of being promoted in clinical use.