腹腔镜辅助下胃癌根治术71例临床报告

Laparoscopy-assisted radical gastrectomy:a report of 71 cases

目的探讨腹腔镜辅助下胃癌根治术的安全性及可行性。方法71例胃癌患者行腹腔镜辅助下根治性胃切除术,其中根治性全胃切除术8例,近端胃大部切除术16例,近端胃大部联合脾脏切除术3例,远端胃大部切除术44例。结果71例患者,除2例中转开腹外,其余69例均成功进行腹腔镜手术。手术用时:全胃切除(343±52)min,近端胃切除(268±62)min,近端胃切除联合脾脏切除(312±64)min,远端胃切除(283±44)min。术中出血量:全胃切除(267±220)ml,近端胃切除(150±103)ml,近端胃联合脾脏切除(333±116)ml,远端胃切除(139±84)ml。清扫淋巴结(34.3±11.8)枚/例。术后患者平均胃肠功能恢复时间(4.1±1.1)d,下床活动时间(3.5±1.0)d,进流质时间(5.0±1.2)d。术后近期效果良好。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,且具有创伤小、术后恢复快等优点。

Objective To investigate the feasibility and safety of laparoseopy-assisted radical gastreetomy for gastric cancer. Methods Seventy-one patients with gastric cancer received laparoseopy-assisted radical gastreetomy for gastric cancer. Among them radical total gastreetomy was performed in 8 eases, proximal partial gastreetomy in 16 eases, proximal partial gastreetomy combined with spleneetomy in 3 eases, and distal partial gastreetomy in 44 eases. Results Sixty-nine eases had laparoscopie-assisted surgery performed successfully, but 2 eases were converted to open surgery. The mean operation time was （343 ± 52） min for total gastreetomy, （268 ± 62） min for proximal gastreetomy, （312 ± 64） min for proximal gastreetomy combined with spleneetomy, and （283 ± 44）min for distal gastreetomy respectively. The mean volume of blood loss was （267 ±220） ml in total gastreetomy, （150 ± 103） ml in proximal gastreetomy, （333 ± 116） ml in proximal gastreetomy combined with spleneetomy, （139 ±84）ml in distal gastrectomy respectively. The mean numbers of harvested lymph nodes were （34. 3 ± 11.8） . The mean time was （4. 1 ± 1. 1） d for gastrointestinal function recovery, （3.5 ± 1. O）d for patients＇ taking general activity, （5.0 ± 1.2）d for taking liquid food. The short-term efficiency was obvious. Conclusions Laparoseopy- assisted radical gastrectomy is a feasible, safe and minimally invasive treatment and can achieve the same outcomes as the open operation.