腹腔镜辅助下进展期胃癌根治术16例临床分析

Laparoscopic-assisted radical gastrectomy for advanced gastric cancer in 16 cases

目的探讨腹腔镜辅助下进展期胃癌根治术的可行性及疗效。方法回顾性分析我院自2009年12月至2010年8月16例腹腔镜辅助下实施进展期胃癌根治术患者的临床资料,其中全胃切除2例、近端胃癌根治8例、远端胃癌根治6例。结果 16例患者顺利完成腹腔镜胃癌根治术,无中转开腹病例。平均手术时间为全胃切除280（230~310）min,近端胃癌根治246（210~276）min,远端胃癌根治230（200~256）min。术中平均出血量为全胃切除280（260~300）mL,近端胃癌根治110（60~180）mL,远端胃癌根治120（70~200）mL。切口长度为5~7 cm。术后患者肛门排气平均3.5（2~4）d,下床活动时间平均为3.5（2~4）d,所有患者随访1~8个月,术后近期恢复良好,无近期并发症,无肿瘤的局部复发,无Trocar种植。结论腹腔镜辅助下行胃癌根治术具有较好的安全性及可靠性,微创手术在胃癌根治中的应用是可行的。

Objective To explore the feasibility and efficacy of laparoscopic-assisted radical gastrectomy for advanced gastric cancer.Methods All 16 patients with advanced gastric cancer receiving laparoscopic-assisted gastrectomy（2 cases of total gastrectomy,8 cases of proximal gastrectomy and 6 cases of distal gastrectomy） in our hospital from December 2009 to October 2010 were analyzed.Results Laparoscopic-assisted gastrectomy was performed successfully on all patients.The average operative time was 280（230～310）min in total gastrectomy,246（210～276）min in proximal gastrectomy and 230（200～256）min in distal gastrectomy.The average blood loss was 280（260~300） mL in total gastrectomy,110（60~180）mL in proximal gastrectomy and 120（70~200）mL in distal gastrectomy.The length of the incision was 5~7cm.The mean time of gastrointestinal function recovery was 3.5（2~4）d and the mean out-of-bed activity time was 3.5（2~4）d.All patients were followed up for 1~8 months.No operation complication,local recurrence and Trocar implant were observed.ConclusionLaparoscopic-assisted gastrectomy is a safe and reliable surgical procedure.Minimally invasive surgery is feasible in radical operation of gastric cancer.