关键词: 胃癌, 全胃切除术, 腹腔镜, 3D, 食管空肠吻合

Abstract: Objective To compare with laparoscopic-assisted total gastrectomy,to evaluate the safety and efficacy of total endoscopic esophagojejunostomy in radical total gastrectomy. Methods The clinical data of 70 patients who underwent 3D laparoscopic radical total gastrectomy from January to July 2019 in our hospital were retrospectively analyzed.The observation group(n=30) underwent total laparoscopic  π-shaped esophagojejunostomy,the control group(n=40) underwent laparoscopic-assisted end-to-side esophagojejunostomy.The operation time,blood loss,anastomosis time,incision length,postoperative pain,postoperative exhaust time,feeding time,hospitalization time and postoperative complications were compared between the two groups. Results R0 resection was performed in both groups.There were no significant differences in age,sex,BMI,pathological features(depth of tumor invasion,regional lymph node metastasis,number of lymph node dissection,degree of tumor differentiation,nerve invasion and vascular invasion) between the two groups(P＞0.05) .In the observation group, there was no perioperative death, anastomotic leakage and other complications, including 1 case of pleural effusion and lung infection, and 1 case of pneumothorax. In the control group, anastomotic leakage, abdominal cavity infection, incision infection and lung infection occurred in 1 case each.The postoperative VAS pain score, surgical incision length and intraoperative anastomosis time of the observation group were better than those of the control group, and the differences between the two groups were statistically significant(P＜0.05).There were no significant differences in operation time,blood loss,incision length,postoperative ventilation time,postoperative feeding time and postoperative hospital stay between the two groups(P＞0.05). Conlusion 3D laparoscopic esophagojejunostomy is safe and effective,with less trauma,less postoperative pain,and does not increase the incidence of postoperative complications and other advantages.

Key words: gastric cancer, total gastrectomy, laparoscopy, 3D, esophagojejunostomy