腹腔镜辅助远端胃切除胃癌根治术的临床研究

Clinical Results of Laparoscopic-assisted Distal Gastrectomy for Gastric Cancer

【目的】探讨腹腔镜辅助远端胃切除胃癌根治术的安全可行性及肿瘤根治性。【方法】2004年12月至2007年12月行腹腔镜辅助远端胃切除胃癌根治术38例。通过手术相关指标、病理诊断及术后恢复指标对手术结果进行评价分析。【结果】38例除1例因术中发现肿瘤侵犯胰腺头部而中转开腹外,余37例均顺利完成腹腔镜辅助远端胃切除胃癌根治手术,术中平均手术时间(295.39±50.38)min,手术切口平均长度(5.6±0.72)cm,术中平均出血量(148.55±96.45)mL;术后胃肠道功能恢复时间平均(3.68±1.21)d,术后平均(3.82±1.43)d开始进食流质。【结论】腹腔镜胃癌根治术是安全可行的,能达到肿瘤根治的要求,具有创伤小、出血少、术后恢复快等优点,可应用于早期胃癌及部分病灶局限、无远处转移的进展期胃癌的手术治疗。

[Objective]To investigate the feasibility, safety and cancer clearance of laparoscopic-assisted distal gastrectomy. [Methods] The clinical data of 38 gastric cancer patients who underwent laparoscopic-assisted distal gastrectomy from Dec. 2004 to Dec. 2007 were retrospectively analyzed. [Results] Except for one case of conversion to open surgery because of the invasion to the head of pancreas, the other 37 patients underwent laparoscopic-assisted distal gastrectomy successfully. The mean operative time was （295. 39 ± 50. 38） min （range from 200min to 420min）. The mean incision length was （5. 6±0. 72） cm （range from 4. 8cm to 6. 5cm）. The mean blood loss was （148. 55±96. 45） mL （range from 50 mL to 600 mL）. [Conclusion] The laparoscopic-assisted distal gastrectomy for gastric cancer is a safe, feasible procedure with the same cancer clearance as open surgery, It has the advantages of tess surgical trauma, less blood loss, faster recovery and shorter hospital stay.