腹腔镜辅助胃癌根治术的临床应用(附36例报告)

目的:探讨开展腹腔镜辅助胃癌根治术的临床安全性及可行性。方法:回顾分析2010年5月至2012年10月36例腹腔镜辅助胃癌根治术患者的临床资料,总结分析患者年龄、临床分期、手术方式、切除范围、手术时间、术中出血量、术后肛门排气时间、并发症及术后随访等情况。结果:36例患者均顺利完成腹腔镜辅助胃癌根治术,无一例中转手术。手术时间平均(220.4±35.7)min,术中出血量平均(115.7±40.3)ml,平均清扫淋巴结(14.3±4.2)枚,胃肠道功能平均恢复时间(81.6±15.6)h,下床活动时间平均(71.1±16.2)h。全组患者无吻合口漏、出血、切口感染等手术并发症发生,术后随访无切口种植。结论:对于早期胃癌或较早的进展期胃癌,腹腔镜辅助胃癌根治术是安全、可行的,手术近期疗效满意,远期疗效尚待进一步观察。对于进展期胃癌,腹腔镜术式的应用及临床疗效仍需进一步探索。

Clinical application of laparoscopic-assisted radical gastrectomy for gastric cancer： with a report of 36 cases

Objective： To evaluate the safety and feasibility of laparoscopic-assisted radical gastrectomy for gastric cancer.Methods： The clinical data of 36 patients who underwent laparoscopic-assisted radical gastrectomy from May 2010 to Oct. 2012 were reviewed and analyzed with the age,clinical stage,surgical procedure,excision extension,operation time,blood loss,time for passage of flatus,complications and follow-up retrospectively. Results： Laparoscopic-assisted radical gastrectomy was completed successfully in 36patients,no one was converted to laparotomy. The mean operation time was（ 220. 4 ± 35. 7） min. The mean blood loss was（ 115. 7 ±40. 3） ml. The mean time for gastrointestinal function recovery was（ 81. 6 ± 15. 6） h after operation,（ 71. 1 ± 16. 2） h for taking normal activity. The mean number of harvested lymph nodes was（ 14. 3 ± 4. 2）. No other complications,such as anastomotic leakage,postoperative bleeding,or incisional infection and no incisional metastasis occurred in follow-up observation. Conclusions： Laparoscopic-assisted radical gastrectomy is a safe and feasible surgical procedure for early gastric cancer and earlier advanced gastric carcinoma. The short-term outcome about laparoscopic-assisted radical gastrectomy is satisfactory,and the long-term outcome still needs further observation. For advanced gastric cancer,the application and clinical efficacy of laparoscopy should be further investigated.