全腹腔镜胃癌根治术常见并发症及中转开腹原因

Common complications and the reasons of conversion to open procedure of totally laparoscopic gastrectomy for gastric cancer

随着腹腔镜胃癌根治术的广泛开展,全腹腔镜胃癌根治术也日渐受到关注。评价全腹腔镜胃癌根治术的相关并发症和中转开腹是评价其安全性和可行性的有效指标。全腹腔镜胃癌根治术较腹腔镜辅助胃癌根治术难度更大,并发症主要包括腹腔内出血、吻合口并发症、腹内疝、肠梗阻、十二指肠残端瘘、胰瘘与腹腔内感染等,中转开腹原因包括主动中转开腹和被动中转开腹。严格把握手术适应证,由具有腹腔镜操作经验的外科医生仔细操作,并不增加并发症和中转开腹的发生率。

Since laparoscopic-assisted radical gastrectomy is getting more popular at present, totally laparoscopic radical gastrectomy has attracted more attention. Complications and the reasons of conversion to open procedure are the important indicators to evaluate the safety and feasibility of totally laparo- scopic radical gastrectomy, and totally laparoscopic radical gastrectomy is more difficult than laparoscopic-assisted radi- cal gastrectomy. The common complications include abdomi- nal bleeding, anastomotic complications, intraperitoneal herni- as, ileus, duodenal stump leakage, pancreatic fistula, intraab- dominal infections, and the reasons of conversion to open pro- cedure include active and passive conversion. Through holding the indication strictly and carefully operated by surgeons with laparoscopic operation experiences, totally laparoscopic radi- cal gastrectomy doesn＇ t increase the incidence of complica- tions and the rate of conversion to open procedure.