Clinical comparison of different laparoscopic surgical approaches for cT1N0M0 gastric cancer

doi:10.3877/cma.j.issn.1674-3946.2026.02.010

Abstract

Abstract:

Objective

To compare the therapeutic effects of different laparoscopic surgical methods for cT₁N₀M₀ gastric cancer.

Methods

Clinical data of 81 patients with cT₁N₀M₀ gastric cancer who underwent laparoscopic gastrectomy from January 2021 to January 2024 were collected. According to the surgical method, patients were divided into the LADG group (n=41, laparoscopic distal gastrectomy) and the LAPPG group (n=40, laparoscopic pylorus-preserving gastrectomy). Data were processed using SPSS 25.0 software, and t test or χ² test was used for comparison. P<0.05 was considered statistically significant.

Results

Compared with the LADG group, the LAPPG group had lower hospitalization costs, higher levels of total protein, albumin, and hemoglobin at 3 months postoperatively, a higher incidence of gastric emptying disorders, and a lower incidence of bile reflux gastritis (P<0.05). There were no significant differences in recurrence rate, survival rate, disease-free survival, or overall survival between the two groups during the 12-month postoperative follow-up (P>0.05).

Conclusion

LADG and LAPPG have comparable therapeutic effects for cT₁N₀M₀ gastric cancer. However, compared with LADG, LAPPG is more conducive to improving the postoperative nutritional status of patients, reducing the occurrence of bile reflux gastritis, and has lower hospitalization costs, but it may increase the risk of postoperative gastric emptying disorders.

Key words: Stomach Neoplasms, Laparoscopes, Gastrectomy, Pylorus Preserving, Nutritional Status, Postoperative Complications

Gan Ru, Chuntao Zhai, Yicheng Tian, Zhengrong Chen. Clinical comparison of different laparoscopic surgical approaches for cT₁N₀M₀ gastric cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2026, 20(02): 134-137.

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Figures/Tables 7

References 21

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组别	例数	性别（例）	年龄（岁，±s）	肿瘤最大径（cm，±s）	身体质量指数（kg/m²，±s）	肿瘤分化程度（例）
组别	例数	男/女	年龄（岁，±s）	肿瘤最大径（cm，±s）	身体质量指数（kg/m²，±s）	低分化/高中分化
LADG组	41	26/15	60.2±4.4	2.6±1.0	23.4±2.1	6/35
LAPPG组	40	24/16	62.1±5.0	2.6±1.0	22.9±2.2	7/33
t/χ²值		0.100	1.797	0.268	1.102	0.123
P值		0.752	0.076	0.790	0.274	0.725

组别	例数	性别（例）	年龄（岁，±s）	肿瘤最大径（cm，±s）	身体质量指数（kg/m²，±s）	肿瘤分化程度（例）
组别	例数	男/女	年龄（岁，±s）	肿瘤最大径（cm，±s）	身体质量指数（kg/m²，±s）	低分化/高中分化
LADG组	41	26/15	60.2±4.4	2.6±1.0	23.4±2.1	6/35
LAPPG组	40	24/16	62.1±5.0	2.6±1.0	22.9±2.2	7/33
t/χ²值		0.100	1.797	0.268	1.102	0.123
P值		0.752	0.076	0.790	0.274	0.725

组别	例数	住院费用（万元）	手术时间（min）	术中出血量（ml）
LADG组	41	5.2±0.4	189.9±17.7	62.3±15.2
LAPPG组	40	4.8±0.4	193.4±21.3	65.8±13.2
t值		4.811	0.810	1.109
P值		<0.001	0.421	0.271
组别	例数	淋巴结清扫数量（枚）	术后首次排气时间（d）	住院时间（d）
LADG组	41	20.6±3.3	3.5±1.0	10.0±1.0
LAPPG组	40	19.3±2.8	3.1±1.0	9.6±1.2
t值		1.947	1.769	1.629
P值		0.055	0.081	0.107

组别	例数	住院费用（万元）	手术时间（min）	术中出血量（ml）
LADG组	41	5.2±0.4	189.9±17.7	62.3±15.2
LAPPG组	40	4.8±0.4	193.4±21.3	65.8±13.2
t值		4.811	0.810	1.109
P值		<0.001	0.421	0.271
组别	例数	淋巴结清扫数量（枚）	术后首次排气时间（d）	住院时间（d）
LADG组	41	20.6±3.3	3.5±1.0	10.0±1.0
LAPPG组	40	19.3±2.8	3.1±1.0	9.6±1.2
t值		1.947	1.769	1.629
P值		0.055	0.081	0.107

组别	例数	时间	总蛋白	白蛋白	血红蛋白
LADG组	41	术前	69.7±6.9	42.1±4.9	129.8±20.1
LADG组	41	术后3个月	64.4±6.4^ab	36.0±3.5^ab	117.3±13.9^ab
LAPPG组	40	术前	70.6±7.1	40.6±5.2	127.3±19.5
LAPPG组	40	术后3个月	68.4±6.3	38.3±4.1	124.3±16.1

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组别	例数	胃排空障碍	胆汁反流性胃炎	切口感染	尿路感染	吻合口漏
LADG组	41	1（2.4）	10（24.4）	3（7.3）	0（0.0）	1（2.4）
LAPPG组	40	9（22.5）	2（5.0）	1（2.5）	1（2.5）	1（2.5）
χ²值		5.790	6.032	0.238	0.000	0.000
P值		0.016	0.014	0.626	0.990	1.000

组别	例数	复发（例）	生存（例）	无瘤生存期（月，±s）	总生存期（月，±s）
LADG组	41	3	41	11.8±0.7	12.0±0.2
LAPPG组	40	4	39	11.8±0.8	12.0±0.2
t/χ²值		0.001	0.000	0.461	1.000
P值		0.973	0.990	0.646	0.323

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