研究腹腔镜辅助保留幽门胃部分切除术（PPG）治疗早期胃中部癌近期疗效。

回顾性分析2018年6月至2020年12月于武汉大学人民医院昌江医疗集团行腹腔镜手术治疗的早期胃中部癌患者94例。根据手术方式的不同，41例行腹腔镜辅助PPG设为观察组，53例行腹腔镜下远端胃切除术设为对照组。比较两组患者围手术期指标、肿瘤学指标及术后并发症发生情况。随访比较两组患者生存情况以及术后3个月营养学指标变化情况。

两组患者术中出血量、排气时间、引流管拔管时间、淋巴结清扫数目、术后住院时间比较差异无统计学意义。观察组手术时间长于对照组，近端肿瘤切缘及远端肿瘤切缘较对照组短，差异有统计学意义（P<0.05）。两组患者切口感染、肺部感染、胃排空延迟、反流性食管炎、吻合口狭窄及并发症总发生率比较，差异无统计学意义。随访19（3~33）个月，均无死亡、肿瘤复发及转移发生。术后3个月，两组患者的血清白蛋白、血红蛋白及体质指数均较术前明显下降（P<0.05），而观察组患者三项营养指标水平显著高于对照组（P<0.05）。

腹腔镜辅助PPG治疗早期胃中部癌兼具安全性、可行性，近期临床疗效满意，值得临床尝试并推广。

To investigate the short-term efficacy of laparoscopic-assisted pylorus preserving gastrectomy (PPG) in the treatment of early middle gastric cancer.

From June 2018 to December 2020, 94 patients with early middle gastric cancer who underwent laparoscopic surgery in Changjiang Healthcare Group of Renmin Hospital of Wuhan University were retrospectively analyzed. According to the different operation methods, 41 patients were the observation group (laparoscopic-assisted PPG) and 53 patients were the control group (laparoscopic-assisted distal gastrectomy). The perioperative indexes, oncology indexes and postoperative complications were compared between the two groups. The survival and nutritional indexes of the two groups were compared after follow-up.

There were no significant differences in intraoperative blood loss, exhaust time, drainage tube extubation time, the number of lymph node dissection and postoperative hospital stay between the two groups. The operation time of the observation group was longer than that of the control group, proximal and distal tumor margins of the observation group were shorter than those of the control group, and the differences were statistically significant (P<0.05). There were no significant differences in the incidence of incision infection, pulmonary infection, delayed gastric emptying, reflux esophagitis, anastomotic stenosis and the total incidence of complications between the two groups. All patients were followed up for 19 (3-33) months, and no death, tumor recurrence or metastasis occurred. Three months after surgery, the serum albumin, hemoglobin and body mass index of the two groups were significantly decreased compared with those before surgery (P<0.05), while the three nutritional indexes of the observation group were higher than those of the control group (P<0.05).

Laparoscopic-assisted PPG is safe and feasible in the treatment of early middle gastric cancer, with satisfactory clinical efficacy in the near future, which is worthy of clinical trial and promotion.