腹腔镜D2根治术治疗无浆膜层侵犯的进展期胃癌129例

Laparoscopic D2 Radical Gastrectomy for Advanced Gastric Carcinoma without Serosal Invasion,a Report of 129 Cases

目的：评价腹腔镜胃癌D2根治术治疗无浆膜层侵犯的进展期胃癌的可行性、安全性及疗效。方法：129例无浆膜层侵犯的进展期胃癌患者中，32例（24．8％）行完全腹腔镜远端胃切除术（total laparoscopic distal gastretomy，TLDG），43例（33.3％）行腹腔镜辅助全胃切除术（laparoscopic-assisted total gastrectomy，LATG），54例（41．9％）行腹腔镜辅助远端胃切除术flaparoscopic-assisted distal gastrectomy，LADG）。结果：本组129例手术均获成功，手术时间为（196±35．5）mins，术中出血量（150±40）mL，术后肠功能恢复时间为（2．7±0．7）d，淋巴结清扫数平均（26±4）枚；术后随访13～70个月，15例有局部复发或远处转移，死亡4例。结论：腹腔镜胃癌D2根治术治疗无浆膜层侵犯的进展期胃癌安全、可行，具有创伤轻、恢复快等优点，有着较好的近远期疗效。

Objective To evaluate the feasibility,safety and therapeutic efficacy of laparoscopic radical gas trectomy for advanced gastric carcinoma without serosal invasion. Methods One hundrd and twenty-nine pa tients with advanced gastric carcinoma without serosal invasion underwent laparoscopic radical gastrectomy. Among them, total laparoscopic distal gastrectomy was performed in 32 cases, laparoscopic-assisted distal gas trectomy was performed in 54 cases,laparoscopic-assisted total gastrectomy was performed in 43 cases. The clini cal parameters including surgical procedure, operation time ,blood loss, time for passage of flatus, complications and pathological findings were studied. Results The surgical procedures in all cases were successfully per formed. The operation time was （196.5_＋35.5） rains, the blood loss was （150_＋40）mL, The average time of intesti nal function recovery was （2.7_＋0.7） clays,The average number of lymph nodes removed was （26~4）, Postoperative follow-up at 13-70 months showed 15 cases suffered local recurrence or distant metastasis with the mumber of tumor related death of 4. Conclusion laparoscopic D2 radical gastrectomy is a feasible and safe surgical pro cedure combined with minimal trauma and fast recovery.Laparoscopic surgery for advanced gastric carcinoma without serosal invasion yields good short and long-term oncologic outcomes.