腹腔镜辅助下胃癌根治术 71例临床报告

目的探讨腹腔镜辅助下胃癌根治术的安全性及可行性.方法 71例胃癌患者行腹腔镜辅助下根治性胃切除术,其中根治性全胃切除术 8例,近端胃大部切除术 16例,近端胃大部联合脾脏切除术 3例,远端胃大部切除术 44例.结果 71例患者,除 2例中转开腹外,其余 69例均成功进行腹腔镜手术.手术用时全胃切除 (343± 52)min,近端胃切除 (268± 62) min,近端胃切除联合脾脏切除 (312± 64) min,远端胃切除 (283± 44)min.术中出血量全胃切除 (267± 220)ml,近端胃切除 (150± 103)ml,近端胃联合脾脏切除 (333± 116)ml,远端胃切除 (139± 84)ml.清扫淋巴结 (34.3± 11.8)枚 /例.术后患者平均胃肠功能恢复时间 (4.1± 1.1)d,下床活动时间 (3.5± 1.0)d,进流质时间 (5.0± 1.2)d.术后近期效果良好.结论 腹腔镜胃癌根治术安全、可行,能够达到与开腹手术相当的根治效果,且具有创伤小、术后恢复快等优点.

Laparoscopy-assisted radical gastrectomy:a report of 71 cases

OBJECTIVE: To investigate the feasibility and safety of laparoscopy-assisted radical gastrectomy for gastric cancer. METHODS: Seventy-one patients with gastric cancer received laparoscopy-assisted radical gastrectomy for gastric cancer. Among them radical total gastrectomy was performed in 8 cases, proximal partial gastrectomy in 16 cases, proximal partial gastrectomy combined with splenectomy in 3 cases, and distal partial gastrectomy in 44 cases. RESULTS: Sixty-nine cases had laparoscopic-assisted surgery performed successfully, but 2 cases were converted to open surgery. The mean operation time was (343 +/- 52) min for total gastrectomy, (268 +/- 62) min for proximal gastrectomy, (312 +/- 64) min for proximal gastrectomy combined with splenectomy, and (283 +/- 44) min for distal gastrectomy respectively. The mean volume of blood loss was (267 +/- 220) ml in total gastrectomy, (150 +/- 103) ml in proximal gastrectomy, (333 +/- 116) ml in proximal gastrectomy combined with splenectomy, (139+/- 84) ml in distal gastrectomy respectively. The mean numbers of harvested lymph nodes were (34.3 +/- 11.8). The mean time was (4.1 +/- 1.1) d for gastrointestinal function recovery, (3.5 +/- 1.0) d for patient's taking general activity, (5.0 +/- 1.2) d for taking liquid food. The short-term efficiency was obvious. CONCLUSION: Laparoscopy-assisted radical gastrectomy is a feasible, safe and minimally invasive treatment and can achieve the same outcomes as the open operation.