探讨预先小切口辅助腹腔镜根治术治疗进展期远端胃癌的临床疗效。

回顾性收集2022年2月至2023年11月115例进展期远端胃癌手术患者的临床资料，依据术式不同分为常规组（n=56，行腹腔镜根治术）和研究组（n=59，行预先小切口辅助腹腔镜根治术）。使用统计学软件SPSS 25.0处理数据，符合正态分布的计量资料以（±s）表示，采用独立样本t检验；术后视觉模拟评分法（VAS）评分采用一般线性重复度量方差分析检验；复发时间采用Kaplan-Meier检验；计数资料用[例（%）]表示，行χ²检验。P<0.05为差异有统计学意义。

研究组患者手术时间短于常规组，术中淋巴结清扫数量多于常规组（P<0.05）；两组患者术后下床活动、首次排气及住院时间比较差异无统计学意义（P>0.05）。术后6h、12h、24h、48h，两组患者VAS评分均逐渐降低（P<0.05）；但术后各时点两组患者VAS评分比较差异无统计学意义（P>0.05）。两组患者术后并发症总发生率及术后12个月复发率比较差异无统计学意义（P>0.05）。研究组复发患者的复发时间长于常规组（P<0.05）。

预先小切口辅助腹腔镜根治术可缩短进展期远端胃癌手术时间，提高术中淋巴结清扫数量，且不会增加术后疼痛及并发症，并能保证良好的肿瘤学疗效，有推广应用价值。

To explore the clinical efficacy of laparoscopic radical resection assisted by a preoperative small incision in the treatment of advanced distal gastric cancer.

The clinical data of 115 patients with advanced distal gastric cancer who underwent surgery from February 2022 to November 2023 were collected retrospectively. According to the different surgical methods, the patients were divided into two groups: Routine Group: 56 patients who underwent conventional laparoscopic radical resection; study Group: 59 patients who underwent laparoscopic radical resection assisted by a preoperative small incision. Data were processed using SPSS 25.0 statistical software. Measurement data conforming to a normal distribution were expressed as (±s) and analyzed by independent samples t test. Postoperative Visual Analogue Scale (VAS) scores were tested by general linear repeated-measures analysis of variance (ANOVA). Recurrence time was analyzed using Kaplan-Meier statistics. Categorical data were expressed as [cases (%)] and analyzed by the χ² test. P<0.05 was considered statistically significant.

The operation time of the Study Group was shorter than that of the Routine Group, and the number of intraoperative lymph node dissections was greater than that of the Routine Group (both P<0.05). There were no statistically significant differences between the two groups in terms of postoperative time to get out of bed, time to first flatus, or length of hospital stay (all P>0.05). At 6h, 12h, 24h, and 48h postoperatively, the VAS scores of both groups decreased gradually (all P<0.05); however, there were no statistically significant differences in VAS scores between the two groups at each postoperative time point (all P>0.05). There were no statistically significant differences between the two groups in the total incidence of postoperative complications or the 12-month postoperative recurrence rate (all P>0.05). The recurrence time of patients with recurrence in the Study Group was longer than that in the Routine Group (P<0.05).

Laparoscopic radical resection assisted by a preoperative small incision can shorten the operation time of advanced distal gastric cancer, increase the number of intraoperative lymph node dissections, without increasing postoperative pain and complications, and can ensure good oncological efficacy. It has value for popularization and application.