腹腔镜胃癌根治术108例临床分析

目的:探讨腹腔镜手术在胃癌根治术中的临床应用价值及应用的广泛性,总结腹腔镜胃癌根治术的临床经验。方法:回顾分析2003年4月～2009年9月108例行腹腔镜手术的胃癌患者的临床资料,探讨腹腔镜手术的手术方式及并发症。结果:106例(98%)完成手术,其中2例因大出血于次日行开放手术,术后感染4例,经用药后治愈,中转开腹手术15例,2例皮下气肿,经处理次日消失。结论:病例选择是腹腔镜胃癌根治术成功的关键,对早期胃癌及胃浆膜小面积浸润的进展期胃癌,施行腹腔镜辅助下的D2胃癌根治术在技术上是安全可行的。术者需经腹腔镜技能培训,有熟练开腹手术的经验和高超的腹腔镜操作水平以及手术组协调配合。腹腔镜手术在临床的应用将会越来越广泛。

Objective： Explore laparoscopic surgery in the clinical value of clinical applications, Summarize the extensive application and clinical experience of laparoscopic surgery for stomach cancer. Methods：Review April 2003 -2009 September 108 routine of laparoscopic surgery patients with stomach cancer, the clinical data of laparoscopic surgery surgical methods and complications. Discusses the ways and laparoscopic surgery complications. Results ： Complete surgical 106 patients （98%）, 2 cases accept open surgery because of the massive hemorrhage the following day, 4 cases by postoperative infection, drug cured after surgery, sigmoidectomy 15 cases, 2 subcutaneous emphysema, after processing, then disappear. Conclusions： laparoscopic gastric cancer cases choice is the key to success, vesssed early cancer and stomach serosal invasion of small area of adanced gastric cancer, aided by laparoscopic vesssed technically gastric D2 is safe and feasible. The operator shall be well trained and have sufficient experience of open surgery as well as sophisticated level. What＇s more,the cooperation of the whole operation team is also important. Laparoscopic surgery in clinical applications will be more and more widely.