腹腔镜技术在胃良性疾病中的应用:附68例报道

Laparoscopic technique in the treatment of benign gastric diseases:a report of 68 cases

目的:探讨腹腔镜技术在治疗胃良性疾病中的运用及其临床价值。方法:回顾分析2002年1月至2007年11月行完全腹腔镜治疗的胃良性病病人68例的临床资料(LG组),并与同期92例开腹手术病人(OG组)在平均手术时间、术中失血、术后恢复平均住院天数等方面进行比较。结果:68例LG组病人均在腹腔镜下顺利完成手术。平均手术时间90 min,平均出血50 ml,平均住院时间6.5 d;2例发生切口感染,无其他严重并发症发生。OG组平均手术时间100 min(P>0.05),平均出血95 ml(P<0.05),平均住院时间12 d(P<0.05);其中7例发生切口感染,3例发生胃排空障碍,并且有1例发生吻合口瘘,1例发生术后肠梗阻。两组相比可见,LG组手术疗效和术后恢复均明显优于OG组。结论:腹腔镜技术在胃良性疾病手术中安全、可行,具有出血少、创伤小、住院时间短的优点,值得推广。

Objective To evaluate the role of laparoscopic technique in the treatment of benign gastric diseases. Methods The clinical data from 68 patients having undergone total laparoscopic gastric resection（LG）, and 92 cases having undergone open gastric surgery （OG） were retrospectively analyzed. Parameters including operation time, intraoperative blood loss, postoperative recovery and duration of hospital stay were compared between the 2 groups. Results All patients in the LG group successfully underwent gastric resection, with a mean operation time of 90 min, an average intraoperative blood loss of 50 ml, and an average hospital stay of 6.5 days; incisional infection occurred in 2 cases with no other serious complications. Compared with the parameters of the LG group, the mean operation time in the OG group was 100 min （P〉0.05）, the average intraoperative blood loss was 95 ml（P〈0.05）, and the average hospital stay was 12 days （P〈 0.05 ）. In the OG group, 7 patients developed incisional infection, 3 disorders of gastric emptying ,one anastomotic fistula, and one bowel obstruction. The therapeutic effects and postoperative recovery of the LG group were significantly superior to those of the OG group. Conclusions Laparoscopic gastric resection is a safe and feasible minimally-invasive surgery approach, with merits of less pain, less bleeding, quicker recovery and shorter hospital stay.