经脐单孔腹腔镜手术治疗胃良性疾病的探讨

Trans-umbilical single incision laparoscopic surgery in benign gastric disease

目的探讨利用传统腹腔镜器械行经脐单孔腹腔镜手术治疗胃良性疾病的临床应用前景。方法 2009年5月至2011年5月,12例胃间质瘤及4例良性消化性溃疡患者完成经脐单孔腹腔镜胃部分切除术、胃大部切除术,总结手术方法及临床疗效。结果 12例胃间质瘤患者顺利完成经脐单孔腹腔镜胃部分切除术,手术平均用时110min,术中平均出血量90ml,术后平均住院时间5d。4例良性消化性溃疡合并幽门梗阻患者中,1例因术中局部粘连重中转开腹,其余3例手术顺利,平均手术时间290min,术中平均出血量220ml,术后平均住院时间7d。全组病例无术后出血、吻合口漏及吻合口梗阻等并发症发生,患者恢复好。结论经脐单孔腹腔镜手术治疗胃良性疾病安全、可行,并可以达到良好的美容效果。

Objective To explore the clinical application of umbilical single-incision laparoscopic surgery（SILS） in the treatment of gastrointestinal stromal tumors（GIST） and the peptic ulcer of gastric with conventional laparoscopic instruments.Methods Preliminary experience with umbilical SILS operation in 12 patients with GIST and 4 patients with ulcer were introduced.Results Umbilical SILS operation in GIST and ulcer were feasible with conventional laparoscopic instruments.One patient with ulcer converted into open surgery.There was no intraoperative or postoperative complications recorded,such as secondary haemorrhage,anastomotic leakage or obstruction.The patients were fully recovered and the single umbilical scar was well healed.Conclusions SILS in benign gastric disease is feasible and safe when performed by experienced laparoscopic surgeons.With advanced surgical technology and technique,truly minimally invasive surgical procedures are feasible.