腹腔镜胃癌根治术

Laparoscopic radical resection of gastric carcinoma： a report of 15 cases

目的评价腹腔镜胃癌根治术（D2）的可行性、安全性以及术后近期疗效。方法回顾性分析2005年5月至2006年8月问15例行腹腔镜胃癌根治术患者的临床资料，包括手术时间、术中出血量、术后胃肠道功能恢复时间、术后并发症、术后病理及随访结果。结果本组15例患者手术全部成功，术中无1例中转开腹。其中5例行完全腹腔镜远端胃切除术，5例行腹腔镜辅助远端胃切除术，4例行腹腔镜全胃切除术，1例行腹腔镜近端胃切除术。手术时间平均为（280±42）min，术中出血量平均为（274±136）ml，术后胃肠道功能恢复时问平均为（2．9±0．8）d，淋巴结清扫数平均为（28±6）枚，无并发症发生。术后随访15例患者9-36个月，无复发转移。结论腹腔镜胃癌根治术安全可行，且具有创伤轻、恢复快等优点。

Objective To evaluate the feasibility, safety and therapeutic efficacy of laparoscopic radical resection for gastric carcinoma. Method In this study, 15 patients with gastric carcinoma underwent laparoscopic radical resection from May 2005 to Aug 2006, clinical parameters including surgical procedures, operation time, blood loss, time for passage of flatus, complications and pathological findings were recorded. Result All operations were successful. Five cases received laparoscopic radical distal gastrectomy, 5 cases received hand-assisted laparoscopic radical distal gastrectomy, laparoscopie total gastrectomy was performed in 4 cases, lparoscopic proximal gastrectomy was performed in 1 case. The operation time ranged from 195 to 350 min, the blood loss was 100 to 600 ml. The average time of intestinal function recovery was （ 2. 9 ± 0. 8 ） days. The average number of lymph nodes dissected were （ 28 ± 6 ）. There was no major postoperative complications. Postoperative follow-up were 24 months in 15 cases, there were no metastasis and tumor recurrence. Conclusion Laparoscopic radical gastrectomy is a feasible and safe surgical procedure for patients of gastric carcinoma.