基层医院开展腹腔镜胃手术的临床体会

The clinical analysis of laparoscopic gastric operation in primary hospital

目的：探讨基层医院应用腹腔镜治疗早期胃癌及胃良性疾病的手术方法,评估其临床应用价值。方法：回顾分析2005年6月至2009年6月为39例胃疾病患者行腹腔镜胃手术的临床资料。21例行胃大部切除术,17例行胃壁良性肿瘤切除术,1例行胃癌根治术。结果：38例成功完成腹腔镜手术,1例中转开腹。手术时间65~320min,平均（170.2±62.5）min;术中出血50~850ml,平均（325.3±107.6）ml;住院5~12d,平均（7.2±1.8）d。术后2例发生并发症,无手术死亡病例。术后随访1~3年,4例早期胃癌患者存活至今。结论：腹腔镜手术患者创伤小,痛苦轻,康复快,住院时间短。只要术前仔细检查,把握手术适应证,术中认真操作,基层医院行腹腔镜手术治疗早期胃癌及良性胃疾病安全可行。

Objective：The aim of the present study was to evaluate the methods and the clinical value of treatment early gastric tumor and benign gastric diseases by laparoscopic operation in primary hospital.Methods：The clinical data of 39 cases with early gastric neoplasm and benign gastric diseases who underwent laparoscopic operation were retrospectively analyzed.1 case of early gastric cancer was treated by radical gastrectomy.Subtotal gastrectomy was adopted in 21 cases.17 cases of gastric submucosal benign tumor were treated by tumor resection.Results：Thirty-eight cases of laparoscopic surgery were successful.1 case was converted to open surgery.The operative time was 65-320min.Mean time was（170.2±62.5）min.The blood loss was 50-850ml,mean blood loss was（325.3±107.6）ml.The hospital stay were 5-12 days.Mean time was（7.2±1.8）d.Postoperative complications were noted in 2 patients.There was no death case.Conclusions：Laparoscopic operation has advantages of less trauma,quicker recovery and shorter hospitalization.Treatment of early gastric tumor and benign gastric diseases with laparoscopic operation is a safe and feasible procedure.