Abstract:
Objective To compare the short- and mid-term efficacy of open and laparoscopic total stomach combined with pancreatic tail splenectomy for T4b gastric cancer.
Methods The data of 117 patients with T4B gastric cancer who underwent surgery from May 2017 to November 2019 were analyzed retrospectively. According to different surgical methods，they were divided into laparoscopic group（n=56 cases，Laparoscopic total stomach combined pancreatic body tail and splenectomy）and open group（n=61 cases，open total stomach combined pancreatic body tail and splenectomy）. SPSS 23.0 statistical software was used for analysis，the measurement data such as perioperative related indicators were expressed as（
±
s），and the independent sample t test was used. Postoperative complications were counted by
χ2 test. The cumulative survival rate was used by Log Rank test.
P<0.05 was considered statistically significant.
Results The operation time in the laparoscopic group was higher than that in the open group，and the amount of intraoperative blood loss，postoperative exhaust time，postoperative eating time，and hospital stay were lower than those of the open group，with statistical significance.（P<0.05）. There were no significant differences in the number of positive lymph node dissections，the total incidence of postoperative complications and the 2-year overall survival rate（41.1% vs. 39.3%）between two groups（P>0.05）.
Conclusion Laparoscopic total stomach combined with pancreatic body tail splenectomy is feasible for T4b gastric cancer. Compared with open surgery，it has certain minimally invasive advantages and does not increase the risk of complications，but it has no obvious advantage in improving prognosis.
Key words:
Stomach neoplasms,
Laparoscopes,
Laparotomy,
Postoperative complications,
Survival rate
Guangtao Zheng, He Huang, Xinian Wen, Lei Wang. Comparison of short-term and medium-term efficacy of open and laparoscopic total gastrectomy combined with distal pancreatectomy and splenectomy in the treatment of T4b gastric cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(01): 84-86.