腹腔镜辅助远端胃癌根治术中、术后早期并发症及其原因分析

Intraoperative and early postoperative complications in laparoscopy-assisted radical distal gastrectomy for gastric cancer

目的探讨腹腔镜辅助远端胃癌根治术中、术后早期并发症及其原因分析。方法回顾性分析我院63例行腹腔镜辅助远端胃癌根治术患者的临床资料,分析术中及术后早期并发症发生的原因,探讨其处理。结果术中并发症14例,包括术中出血5例,皮下气肿3例,高碳酸血症2例,横结肠系膜损伤4例;中转开腹2例,中转率为3.17%,1例为术中血管损伤引起出血,1例为严重高碳酸血症;余均在腹腔镜下成功处理。术后早期并发症11例,包括术后腹腔内出血2例,戳孔感染2例,戳孔血肿1例,十二指肠残端瘘2例,吻合口瘘1例,吻合口狭窄1例,吻合口出血1例,淋巴漏1例。结论了解腹腔镜辅助远端胃癌根治术并发症的原因和种类是减少术中和术后早期并发症的关键。

Objective To investigate the intraoperative and early postoperative complications in laparoscopy-assisted radical distal gastrectomy for gastric cancer,and analyze their causes and treatments.Methods Clinical data of 63 patients undergoing laparoscopy-assisted distal gastrectomy for gastric cancer were analyzed retrospectively.The causes and treatments of intraoperative and early postoperative complications were investigated.Results Intraopearative complications occurred in 14 patients,including intraoperative bleeding in 5 cases,pneumohypoderma in 3 cases,hypercapnia in 2 cases,transverse mesocolon injury in 4 cases.Two patients had to convert to open operation with a conversion rate of 3.17%(2/63),including severe intraoperative bleeding because of vessels injury in one case,severe hypercapnia in the other.Other intraoperative complications were managed successfully through laparoscopy.Early postoperative complicatiens occurred in 11 patients,including intra-abdominal bleeding,port-site infection,duodenal stump leakage respectively in 2 cases,and port-site hematoma,anastomotic leakage,anastomotic stenosis,anastomotic bleeding and lymphorrhagia respectively in one case.Conclusion It is the key point to reduce intraoperative and early postoperative complications that surgeons get familiar with the types and causes of such complications.