腹腔镜辅助下根治胃癌的23例临床报告

Clinlic preliminary report on laparoscopic-assisted radical gastrectomy in 23 cases

目的:探讨腹腔镜下辅助根治胃癌的可行性、方法和效果。方法:临床分析行腹腔镜根治术的胃癌病23例,包括全胃切除术3例,近端胃大部切除术4例,远端胃大部切除术16例。结果:23例中,除2例中转开腹外,其余21例均成功地进行腹腔镜手术。手术平均时间:全胃切除401(340～475)min,近端胃切除254.3(212～340)min,远端胃切除318.5(270～377)min。术中平均出血量:全胃切除650(400～900)ml,近端胃切除125(50～200)ml,远端胃切除170(100～300)ml。每例平均清扫淋巴结18.3(8～41)枚。术后病人平均胃肠功能恢复时间为3.5(2～5)d,下床活动时间为3.4(2～5)d,进流质时间4.5(3～6)d;术后近期恢复良好。结论:腹腔镜胃癌根治术安全、可行,能够达到与开腹手术相当的根治效果,且有创伤小、术后恢复快等优点。

Objective To explore the feasibility,methodology and effect of laparoscopic-assisted radical gastrectomy.Method In a total of 23 gastric cancer cases, there were 3 cases were radical total gastrectomy,4 cases of proximal gastrectomy ,and 16 cases of distal gastrectomy. Results Twenty-one cases underwent laparoscopic-assisted surgery successfully and the other 2 were converted to open surgery. The average operative time of total gastrectomy was 401 (range 340-475) min,while it was 254.3(range 212-340) min in proximal gastrectomy and 318.5(range 270-377) min in distal gastrectomy . The average blood loss was 650 (range 400-900) ml in total gastrectomy,125(range 50-200) ml in proximal gastrectomy and 170(range 100-300) ml in distal gastrectomy The average number of lymph nodes dissected was 18.3 (range 8-41). The average time of recovery of bowel activity was 3.5 (2-5)days, 3.4 (2-5) days and that for oral intake was 4.5(3-6) days after operation. No operative complications were observed. Conclusions Laparoscopic radical gastrectomy is a safe, procedure and matches the results of open surgery. It also leads to less trauma and rapid recovery.