腹腔镜技术在远端胃癌根治术中的应用

The application of laparoscopic technique in distal gastrectomy for gastric cancer

目的探讨腹腔镜技术在远端胃癌根治术中的应用与效果。方法收集2009年1月—2011年5月新疆医科大学第一附属医院胃肠外科54例腹腔镜远端胃癌根治术患者的临床资料,并随访其生存情况。结果 54例患者中有45例顺利完成腹腔镜手术,9例中转开放手术,无手术死亡病例,无术后出血、吻合口漏、吻合口狭窄发生。手术平均时间210min,术中出血量为50～150mL,术后2～4d胃肠功能恢复。所有标本残端无癌细胞浸润或残留,清扫淋巴结数6～27枚。术后随访至2011年5月,死亡1例,局部复发1例。结论腹腔镜远端胃癌根治术具有操作安全、微创、术后恢复快等优点,其远期疗效有待进一步随访。

Objective Tostudy the application and effects of laparoscopy technique in distal gastrectomy for gastric cancer. Methods The clinical data from January 2009 to May 2011 of 54 cases of laparoscopic radical rectectomy for distal gastric cancerpatients were analyzed retrospectively. Results 45 cases of 54 patients successfully completed by laparoscopic surgery. 9 cases were converted to open laparotomy, no operative deaths and postoperative bleeding and anastomotic leakage、 anastomotic stenosis. The average operative time break 210min,Blood loss was 50-150ml,2-4d postoperative recovery of gastrointestinal function,all specimens stump were found with non-cancer cell infiltration, number of lymph node dissection of 6-27. The average hospital stay after surgery is 8d. There were 1 case died and 1 case was local recurrence in the postoperative follow-up until May 2011. Conclusion The purpose of abdominal radical surgery not only can be achieved by the laparoscopic distal gastric cancer resection, but also safe, minimally invasive, quick recovery and the advantages of high rate of sphincter preservation. However, its long-term effect has yet to be proved by the follow-up observation of a large number of cases.