腹腔镜辅助远端胃癌根治术30例分析

Laparoscopic Assisted D2 Distal Radical Gastrectomy for 30 Gastric Cancer Cases

目的:探讨腹腔镜辅助行远端胃癌根治术的可行性。方法:2007年6月—2008年8月行腹腔镜远端胃癌根治术30例。结果:30例均在腹腔镜下完成远端胃癌根治术,无中转开腹手术病例。平均手术时间:312(256～450)min。术中出血量:145(60～250)mL,术中均未输血。平均清扫淋巴结21.1(16～35)枚。术后患者平均胃肠功能恢复时间44(36～56)h,下床活动时间56(24～96)h。常规置空肠营养管,术后肠内营养开始时间36(24～48)h,进流质时间2.6(2～4)d。术后近期生活质量良好。结论:早期及较早的远端进展期胃癌经腹腔镜辅助行D2根治术是安全可行的,根治效果与开腹手术相近,且具有创伤小、术后恢复迅速等优点。

Objective：To investigate the feasibility of laparoscopic D2 distal radical gastrectomy. Methods：30 cases of gastric cancer underwent laparoscopic D2 distal radical gastrectomy during June, 2007 and Aug, 2008. Results： All 30 patients underwent laparoscopic D2 distal radical gastrectomy successfully, without conversion to open surgery. The mean operation time was 312（256-450）min, the average blood loss was 145（60-250）ml without blood transfusion, the average harvested lymph nodes number was 21.1 （16-35）. The average time of postoperative gastrointestinal function recovery and bedside activity was 44（36 56） h; 56（24- 96） h respectively. The average start time of intestinal nutrition intake via routinely placed jejunum nutrition tube and oral liquid intake was 36 （min-max： 24 - 48） h and 2.6 （rain-max： 2 - 4） d. Short-term postoperative QoL was satisfying. Conclusion ： Laparoscopic D2 Distal Radical Gastrectomy performed on early and early-advanced gastric cancer cases is safe and feasible, with similar results of open surgery. It also has the advantage of minimal invasion and speedy postoperative recovery.