Comparison of Invasiveness Between Laparoscopy-Assisted Total Gastrectomy and Open Total Gastrectomy
Comparison of Invasiveness Between Laparoscopy-Assisted Total Gastrectomy and Open Total Gastrectomy
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DOI：
10.1007/s00268-009-0208-y
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发表时间：
2009-11-01
影响因子：
2.6
通讯作者：
Kondo, Yukifumi
中科院分区：
文献类型：
--
作者：
Kawamura, Hideki;Yokota, Ryoichi;Kondo, Yukifumi
背景 由于迄今为止关于腹腔镜辅助全胃切除术（LATG）与开腹全胃切除术（OTG）相比的侵入性的研究很少，因此 LATG 的微创性尚不清楚。 方法 OTG 队列包含 35 例，于 2003 年 4 月至 2005 年 10 月进行。 LATG 队列包含 46 例，于 2005 年 11 月至 2008 年 11 月进行。 术后随时间的变化评估了与微创性相关的各种参数。我们使用 Wong-Baker FACES 疼痛评定量表来评估疼痛。使用术后第 1-7 天 (POD) 的每日最大值来分析生命体征和面部评分。术前及术后第1、4、7、10天进行血液学检查。以室内空气中氧饱和度（SaO(2)）达到95%以上的天数来评价呼吸功能。结果术后第1、4、5、7天，LATG组疼痛评分显着降低。术后第7天，LATG组体温显着降低。白细胞显着降低。 LATG 患者在 POD 10 时显示计数，C 反应蛋白计数在 POD 1 时显示。LATG 组在 POD 1、4 和 7 时观察到显着较高的血清总蛋白值。LATG 组在 POD 4 和 7 时发现血糖水平显着降低。LATG 组中直到室内空气中 SaO(2) 达到 95% 或更高的天数明显较少。结论 LATG 似乎是一种比 OTG 侵入性更小。
Background Because only a few studies have been performed to date on the invasiveness of laparoscopy-assisted total gastrectomy (LATG) compared with open total gastrectomy (OTG), the minimal invasiveness of LATG has been unclear.Methods The OTG cohort contained 35 cases, which were performed from April 2003 to October 2005. The LATG cohort contained 46 cases, which were performed from November 2005 to November 2008. Postoperative changes over time in various parameters relating to minimal invasiveness were evaluated. We used the Wong-Baker FACES Pain Rating Scale to evaluate pain. Vital signs and a face scale were analyzed using daily maximum values on postoperative days (POD) 1-7. A hematological examination was performed on the preoperative day and POD 1, 4, 7, and 10. The number of days until oxygen saturation level (SaO(2)) was 95% or more in room air was used to evaluate respiratory function.Results Significantly lower pain scores were obtained in the LATG group on POD 1, 4, 5, and 7. There was a significantly lower body temperature in the LATG group on POD 7. A significantly lower white blood cell count was revealed for LATG patients on POD 10, and for C-reactive protein on POD 1. Significantly higher serum total protein values were observed in the LATG group on POD 1, 4, and 7. Significantly lower blood sugar level was found in the LATG group on POD 4 and 7. The number of days until SaO(2) was 95% or more in room air was significantly fewer in the LATG group.Conclusions LATG seems to be a less invasive procedure than OTG.