LTG淋巴结清扫路径对肥胖胃癌患者手术情况、并发症及生活质量的影响OA

Objective:To investigate the effects of splenic gate priority dissection pathway versus traditional midline approach dissection pathway on postoperative complications and quality of life in obese gastric cancer patients undergoing laparoscopic total gastrectomy(LTG),providing clinical evidence for surgical strategy selection in obese gastric cancer patients.Method:A retrospective analysis was conducted on the clinical data of 104 obese gastric cancer patients treated with LTG from May 2022 to May 2025 in Jiujiang NO.1 People's Hospital.Patients were divided into an observation group(splenic gate priority dissection,n=52)and a control group(traditional midline approach dissection,n=52)based on lymph node dissection pathways.Surgical-related indicators(operational time,intraoperative blood loss,number of lymph nodes dissected)and postoperative complication rates(anastomotic leakage,intra-abdominal hemorrhage,pancreatic fistula,pulmonary infection,etc.)were compared between the two groups,quality of life was assessed before the operation and at 3 and 6 months postoperatively.Result:The observation group exhibited significantly less intraoperative blood loss than the control group,and significantly higher number of lymph nodes dissected in group 10 and group 11(P<0.05).No statistically significant differences were observed in operative time and total lymph node dissection numbers between the two groups(P>0.05).The observation group had significantly lower overall complication rates than the control group,with pancreatic fistula incidence being statistically significantly lower than the control group(P<0.05).No statistically significant differences were noted in the rates of anastomotic leakage,intra-abdominal hemorrhage,or pulmonary infection between the two groups(P>0.05).At 3 and 6 months postoperatively,the observation group demonstrated significantly better scores in physical function,role function,and emotional function of European Organization for Research and Treatment of Cancer quality of life questionnaire-core 30(EORTCQLQ-C30)as well as the scores for food restriction and anxiety symptoms in the quality of life questionnaire-stomach cancer 22(QLQ-STO22)compared to the control group(P<0.05).Conclusion:In obese gastric cancer patients undergoing LTG,the splenic gate priority lymph node dissection pathway reduces intraoperative bleeding,improves the thoroughness of splenic gate regional lymph node dissection,decreases postoperative complication rates,and facilitates better postoperative quality of life recovery.