目的

探讨单切口腹腔镜下胃癌根治术治疗早中期胃癌的临床疗效。

方法

回顾性分析2021年6月至2024年6月150例早中期胃癌患者资料，将86例行单切口腹腔镜下胃癌根治术的患者纳入单孔组，64例行传统五孔腹腔镜下胃癌根治术的患者纳入多孔组。采用SPSS 25.0统计软件分析数据，胃肠激素指标、视觉模拟评分法（VAS）及焦虑自评量表（SAS）评分等计量资料以（）表示，行独立样本t检验；术后并发症发生情况等计数资料行χ²检验。P<0.05表示差异有统计学意义。

结果

单孔组患者手术时间长于多孔组、术中出血量少于多孔组、首次排气时间短于多孔组（P<0.05），但两组患者淋巴结清扫数、住院时间比较差异无统计学意义（P>0.05）。术后2d，两组患者血清胃动素（MOT）、胃泌素（GAS）水平均较术前降低，但单孔组高于多孔组（P<0.05）。两组患者术后并发症总发生率比较无差异（P>0.05）。两组患者术后7d VAS评分比较无差异（P>0.05）；单孔组术后7d SAS评分低于多孔组（P<0.05）。

结论

较传统多孔腹腔镜根治术，单切口腹腔镜下胃癌根治术虽然手术时间较长，但术中出血少，患者术后胃肠功能恢复快，且不影响淋巴结清扫，可减轻患者术后焦虑程度。

Objective

To explore the clinical efficacy of laparoscopic radical gastrectomy with a single incision in the treatment of early and middle-stage gastric cancer.

Methods

The data of 150 patients with early and middle-stage gastric cancer from June 2021 to June 2024 were retrospectively analyzed. 86 patients who underwent laparoscopic radical gastrectomy with a single incision were included in the single-port group, and 64 patients who underwent traditional laparoscopic radical gastrectomy with five ports were included in the multi-port group. The SPSS 25.0 statistical software was used to analyze the data. Measurement data such as gastrointestinal hormone indexes, Visual Analogue Scale (VAS) scores, and Self-Rating Anxiety Scale(SAS) scores were expressed as (), and independent sample t test was performed; χ² tests were performed on count data such as the occurrence of postoperative complications. P<0.05 indicated a statistically significant difference.

Results

The operation time of patients in the single-port group was longer than that in the multiport group, the intraoperative blood loss was less than that in the multi-port group, and the first exhaust time was shorter than that in the multi-port group (P<0.05). However, there was no statistically significant difference in the number of lymph node dissections and the length of hospital stay between the two groups (P>0.05). Two days after the operation, the levels of serum motilin (MOT) and gastrin (GAS) in both groups were lower than those before the operation, but those in the single-port group were higher than those in the multi-port group(P<0.05). There was no difference in the total incidence of postoperative complications between the two groups(P>0.05). There was no difference in the VAS scores between the two groups 7 days after the operation (P>0.05);the SAS score of the single-port group 7 days after the operation was lower than that of the multi-port group(P<0.05).

Conclusion

Compared with the traditional multi-port laparoscopic radical gastrectomy, although the operation time of laparoscopic radical gastrectomy with a single incision is longer, the intraoperative blood loss is less, the postoperative gastrointestinal function of patients recovers faster, and it does not affect the lymph node dissection. It can reduce the degree of postoperative anxiety of patients.