腹腔镜辅助胃癌根治81例分析

Analysis of Efficacy and Security of Laparoseopic-assisted Radical Gastrectomy:Report of 81 Cases

[目的]比较腹腔镜辅助远端胃癌根治与腹腔镜辅助胃癌全胃切除的临床资料,探讨腹腔镜辅助全胃切除术的可行性及安全性。[方法]回顾性分析接受腹腔镜辅助胃癌根治病例81例的临床资料,其中LADG组58例行腹腔镜辅助远端胃癌切除,LATG组23例行腹腔镜辅助全胃切除。[结果]与腹腔镜辅助远端胃癌根治相比,腹腔镜辅助全胃切除组手术时间统计学延长。术中出血量、术中并发症发生率均增加,但是差异无统计学意义。胃肠功能恢复时间、术后引流管拔除时间、术后住院时间均无统计学差异。[结论]腹腔镜辅助全胃切除手术难度相对较大,术中并发症发生率高,但是总体安全可行,可在条件成熟,腔镜胃癌技术娴熟的技术上逐步开展。

[Purpose] To evaluate the feasibility and safety of laparoscopy-assisted total gastrectomy（LATG） for the surgical treatment of gastric cancer. [Methods] The clinical data of 81 cases with gastric cancer received laparoscopy-assisted radical gastrectomy were analyzed retrospectively.Among them 58 cases underwent laparoscopy-assisted distal gastrectomy（LADG） and 23 cases underwent laparoscopy-assisted total gastrectomy（LATG）. [Results] Compared to LADG,LATG experienced longer operation time. The intraoperative blood loss and intraoperative complications were increased in LATG,but the difference was no statistical significance. There were no significant difference in gastrointestinal function recovery,removal time of drainage pipe and postoperative hospital stay between LADG and LATG. [Conclusion] Laparoscopy-assisted total gastrectomy is a complex procedure which hard to perform,and with a high rate of intraoperative complications. But it is feasible and safe in general. It can be performed by surgeons who are experienced in laparoscopic gastrectomy.