腹腔镜在胃癌根治术中的应用

The application of laparoscopy in the radical gastrectomy

目的：探讨腹腔镜胃癌根治术的可行性和效果。方法：分析腹腔镜胃癌根治术16例患者的临床资料，其中全胃切除术4例，近端胃大部切除术3例，远端胃大部切除术9例。结果：16例均顺利完成腹腔镜手术。手术平均时间：全胃切除术380min（350～410min），近端胃大部切除术236min（210～259min），远端胃大部切除术273min（250～310min）。术中平均出血量：全胃切除术500ml（400～600m1），近端胃大部切除术120ml（50～170m1），远端胃大部切除术140ml（70～200m1）。术后患者平均胃肠功能恢复时间为3．2d（2～4d），下床活动时间为3．3d（3～4d），开始进流质时间3．9d（3～5d），术后近期恢复良好。结论：腹腔镜胃癌根治手术安全、可行，能够达到与开腹手术相当的根治效果。

Objective： To explore the feasibility, method and effect of laparoscopically-assisted radical gastrectomy. Methods： in a total of 16 cases gastric cancer, there were 4 cases receiving radical total gastrectomy, 3 cases receiving proximal gastrectomy, and 9 cases receiving distal gastrectomy. Results： 16 cases underwent laparoscopically-assisted surgery successfully and there was no conversion to open surgery. The average operative time of total gastrectomy was 380min（250-410min）, while it was 236min（210-259min） in proximal gastrectomy and 273min（250-310min） in distal gastrectomy. The average blood loss was 500ml（400-600ml） in total gastrectomy, 120ml（50-170ml） in proximal gastrectomy, and 140ml（70-200ml） in distal gastrectomy. The average time of recovery of bowel function was 3.2 d （ 2 -4 d ）. Time of bedside movement was 3.3 d （ 3-4 d ） and the average tim e of oral intake was 3.9 d （ 3-5 d ） after operation. No complication was oberserved. Conclusions： Laparoscopic radical gastrectomy is a safe procedure and matches the results of open surgery. It also leads to less trauma and rapid recovery.