完全腹腔镜胃远端癌根治术

Completely laparoscopic radical correction of gastric distal end carcinoma

目的探讨完全腹腔镜下胃远端癌根治术的方法及可行性。方法2000年4月～2006年3月,16例胃远端癌行完全腹腔镜胃远端癌根治术。结果13例患者手术获成功,3例因为肿瘤侵犯周围脏器中转开腹,3例同时行腹腔镜胆囊切除术。手术时间250～300min,术中出血10～160mL。术后平均2.3d胃肠功能恢复,术后8～15d出院。3例患者第一站淋巴结阳性各1～3粒,1例胃窦印戒细胞癌第一站第二站共36个阳性淋巴结。无并发症发生。13例手术成功者术后随访2～60个月,1例术后18个月死于肺转移,其余12例无复发转移(已平均无瘤生存21个月)。结论腹腔镜技术熟练掌握后,完全腹腔镜胃远端癌根治术手术可行,术野显露清楚,可以对早期胃远端癌完成根治性切除术,术后有恢复快的优点,值得进一步探索。

[Objection] To describe a technique of completely laparoscopic radical correction of gastric distal end carcinoma. [Method] 16 patients of gastric distal end carcinoma received totally laparoscopic gastric radical correction from 2000.4 to 2006.3. [Result] Operations were successfully done for 13 patients. 3 cases were reversed into open surgery because carcinoma offended environment. 3 cases received laparoscopic cholecystectomy at the same time. The operative time ranged from 250 to 300 min,the blood loss was 10 to 160 mL. The average time of intestinal function recovery was 2.3 days. The hospital stay ranged from 8 to 15 days. 3 patients had 1 or 3 positive lymph nodes of No.1. 1 case had 36 positive lymph nodes of No.1 and No.2 in signet-ring cell carcinoma of sinus ventriculi. Postoperative follow-up were 2-60 months in 13 cases. Only 1 case succumbed to pulmonary metastasis after 18 months, others were no complications and relapse （the average of live is 21months）. [Conclusion] The completely laparoscopic radical correction of gastric distal end carcinoma was safe and effective for gastric distal end carcinoma with the advantages rapid recovery and short hospitalization. It＇s worth to further research.