腹腔镜胃癌手术并发症的预防和处理

Management and Prophylaxis of Complications in Laparoscopic Gastrectomy

目的总结腹腔镜胃癌手术并发症的现状,探讨腹腔镜下胃癌手术的陷阱和手术并发症的预防及处理办法。方法复习国内、外相关文献,并结合自己的临床经验进行分析。结果腹腔镜胃癌手术并发症主要有手术本身和人工气腹相关并发症。腹腔镜下视野的局限,立体空间和手指触觉的丧失,新器械、新技术的使用以及工作环境的改变,增加了手术难度和发生并发症的可能。清楚的镜下手术解剖层次,正确的淋巴结清扫方法和消化道重建,是减少腹腔镜胃癌手术并发症发生的基础。结论掌握正确的手术操作原则可以减少腹腔镜胃癌手术并发症的发生。

Objective To summarize the current status and the management and prophylaxis of complications in laparoscopic gastrectomy.Methods The literatures on laparoscopic gastrectomy in domestic and abroad were reviewed and analyzed combined with our experiences.Results The complications of laparoscopic gastrectomy primary attributed to surgery itself and pneumoperitoneum.Limited field under laparoscopy,loss of three-dimensional space and finger touch,new instrument and technology and working conditions increased the difficulty of operation and the possibility of surgical complications.Clear anatomical layer under laparoscopy,accurate dissection of lymph nodes,and digestive tract reconstruction were the basis to reduce the complications in laparoscopic gastrectomy.Conclusion Correct surgical procedures may reduce the occurrence of complications in laparoscopic gastrectomy.