完全腹腔镜下远端胃癌根治术的临床体会

Clinical experience of totally laparoscopic distal resection for gastric carcinoma

目的总结完全腹腔镜下远端胃癌根治术的体会。方法确诊为远端胃癌患者12例，均行完全腹腔镜下远端胃癌根治术，统计其手术时间、胃肠功能恢复时间、住院时间及术后并发症等。结果12例患者手术均获成功，无中转开腹，无围手术期死亡。手术时间（220.36±26.67）分钟，术后胃肠功能恢复时间（2.31±1.26）天，住院时间（9.35±3.47）天。术后出现切口感染2例，给予换药、理疗4天后缓解，术后慢性疼痛1例。3例患者术后出现不同程度的反酸、嗳气，给予口服潘妥洛克，2周后症状缓解。术后中位随访时间10个月，无复发转移。结论完全腹腔镜下远端胃癌根治术安全有效，但术后可能引起不同程度的反酸、嗳气。

Objective To discuss the methods and feasibility of totally laparoscopic distal resec-tion for gastric carcinoma. Methods Twelve patients who were diagnosed as distal gastric carcinoma were treated with totally laparoscopic resection. The operation time,recovery time of gastrointestinal function, length of hospital stay and postoperative complications were recorded. Results Operations were success-fully performed in all patients. There was no conversion to open surgery. No perioperative death occurred. The operation time was（220. 36±26. 67）min,the postoperative gastrointestinal function recovery time of was（2. 31 ± 1. 26）d,and the hospitalization time was（9. 35 ± 3. 47）d. There were two patients with wound infection,and they recovered after administering medication and physiotherapy. One case of chronic pain after surgery occurred. Three patients with different degrees of acid reflux and belching were treated with Pantoloc and recovered after two weeks. None of them had a recurrence during a median follow-up pe-riod of 10 months. Conclusion The totally laparoscopic distal resection for gastric carcinoma is safe and effective. It has the advantages of rapid recovery and short hospitalization,which are worthy of being spread. However,it may cause different degrees of acid reflux,belching and other symptoms.