腹腔镜辅助胃癌根治术105例

Laparoscopic-assisted radical gastrectomy:a report of 105 cases

目的探讨腹腔镜辅助胃癌根治术的安全性及可行性。方法对105例胃恶性肿瘤患者行腹腔镜辅助根治性胃切除术,其中根治性全胃切除术7例,近端胃大部切除术27例,近端胃大部联合脾脏切除术3例,远端胃大部切除术68例。结果 105例手术均获成功。手术时间:全胃切除术300～435min,平均(38l±91)min;近端胃切除术212～390 min,平均(279±73)min;近端胃切除联合脾脏切除术265～405 min,平均(312±64)min;远端胃切除术230～360 min,平均(281±69)min。术中出血量:全胃切除术20～900 ml,平均(260±202)ml;近端胃切除术20～400 ml,平均(200±153)ml;近端胃联合脾脏切除术200～400 ml,平均(333±116)ml;远端胃切除术20～450 ml,平均(140±82)ml。平均清扫淋巴结(34.2±20.5)枚。术后胃肠功能恢复时间平均(3.5±1.4)d,下床活动时间平均(3.0±1.6)d,进流食时间平均(4.9±1.7)d。术后近期效果良好。结论腹腔镜辅助胃癌根治术安全可行,且具有创伤小、术后恢复快等优点。

Objective To investigate the feasibility and safety of laparoscopic-assisted radical gastrectomy for gastric cancer. Methods One hundred and five patients with gastric cancer received laparoscopic-assisted radical gastrectomy, radical total gastrectomy were performed in 7 cases, proximal gastrectomy in 27 cases, proximal gastrectomy combined with splenectomy in 3 cases and distal gastrectomy in 68 cases. Results One hundred and five cases had laparoscopic-assisted radical gastrectomy successfully. The mean operation time was 381 ± 91 （300-435） min for total gastrectomy, 279 ± 73 （ 212- 390） min for proximal gastrectomy, 312 ± 64 （ 265-405 ） min for proximal gastrectomy combined with splenectomy, 281 ± 69 （230-360）min for distal gastrectomy, respectively. The mean blood loss was 260 ± 202（20-900）ml in total gastrectomy, 200 ± 153（20-400）ml in proximal gastrectomy, 333 ± 116（200-400） ml in proximal gastrectomy combined with splenectomy, 140 ± 82 （20-450） ml in distal gastrectomy, respectively. The mean number of harvested lymph nodes was 34.2 ± 20.5 （ 8-83 ）. The mean time for gastrointestinal function recovery was 3.5 ± 1.4（2-5） days, 3.0 ± 1.6（2-6） days for patients＇taking normal activity, 4. 9 ± 1.7（3-7） days for taking liquid food. The short-term efficiency was obvious. Conclusions Laparoscopic-assisted radical gastrectomy is a feasible and safe surgical procedure combined with minimal trauma and fast recovery.