腹腔镜辅助下胃癌根治术的临床应用

Clinical application of laparoscopic-assisted radical gastrectomy for gastric cancer

目的探讨腹腔镜辅助下胃癌根治术的方法及临床应用价值。方法回顾性分析2010年1月至2011年4月重庆市开县人民医院18例接受腹腔镜辅助下胃癌根治术患者的淋巴结清扫数目、术后胃肠功能恢复时间、术中出血量、手术时间、术后卧床时间、术后住院时间,并与同期30例开腹手术比较。结果 18例患者均成功接受腹腔镜辅助下胃癌根治术,腹腔镜组与开腹组的平均淋巴结清扫数目分别为(49.6±10.7)枚及(47.8±8.5)枚;术后胃肠功能恢复时间分别为(62.1±11.2)h及(81.6±16.8)h;术中出血量分别为(224.3±33.0)ml及(217.7±25.8)ml;手术时间分别为(274.7±17.9)min及(201.3±9.8)min;术后卧床时间分别为(28.9±4.4)h及(62.1±7.3)h;术后住院时间分别为(6.17±0.99)d及(10.9±0.77)d。结论与同期开腹手术比较,腹腔镜辅助下胃癌根治术具有手术创伤小、术后恢复快的优点,能够达到与开腹手术相当的根治效果。

Objective To investigate clinical value of laparoscopic-assisted radical gastrectomy in the treatment of gastric cancer.Methods The clinical data of eighteen patients with gastric cancer undergoing laparoscopic-assisted radical gastrectomy（the study group） were retrospectively analyzed and compared with that of 30 patients treated by open surgery（the control group）,including the number of dissected lymph nodes,the time for gastrointestinal recovery,intraoperative blood loss,the mean operation time,the time for out-of-bed activity,average length of hospital stay after operation.Results The operation was performed successfully in all the eighteen cases in the study group.The number of dissected lymph nodes,the time for gastrointestinal recovery,intraoperative blood loss,the mean operation time,the time for out-of-bed activity,and the average length of hospital stay after operation for the two groups were（49.6±10.7） and（47.8±8.5） h,（62.1±11.2） h and（81.6±16.8） h,（224.3±33.0） ml and（217.7±25.8） ml,（274.7±17.9） min and（201.3±9.8） min,（28.9±4.4） and（62.1±7.3） h,（6.17±0.99） days and（10.9±0.77） days,respectively.Conclusion Laparoscopic-assisted radical gastrectomy can achieve the same therapeutic efficacy as open surgery,with the advantages of minor trauma and fast postoperative recovery.