吸引器在腹腔镜胃癌根治术中的应用体会

目的总结吸引器在腹腔镜胃癌根治术中的应用体会。方法回顾性分析2014年7月~2016年6月,我院512例腹腔镜胃癌根治术患者的临床和手术资料。结果本组患者平均体质量指数(BMI)为(22.8±3.5)kg/m~2(17.6~30.2 kg/m~2,),其中超重和肥胖98例(BMI≥24kg/m~2)。术中清扫胃主要供应血管周围淋巴结时,一助右手持吸引器配合左手持肠钳来暴露术野、及时吸除气液进而提供良好术野。手术时间100~180分钟,平均(135±30)分钟。术中出血量50~200ml,平均(100±50)ml。中转开腹率为2.15%。术中未发生严重并发症。结论腹腔镜胃癌根治术中,尤其是针对超重和肥胖患者,一助熟练运用吸引器吸引、提拉、戳剥等功能,可提供良好的手术视野,降低手术难度,有效控制出血,缩短手术时间,减少中转开腹率。

Application of aspirator in laparoscopic radical gastrectomy for gastric cancer

Objective To summarize the application experiences of aspirator in laparoscopic rad-ical gastrectomy for gastric cancer. Methods During the period from July 2014 to June 2016,512 cases of laparoscopic radical gastrectomy for gastric cancer in our hospital were retrospectively analyzed. Results The patients with average body mass index(BMI)was 22. 8 ± 3. 5(17. 6-30. 2)kg/ m2 ,including 98 ca-ses of overweight and obesity(BMI≥24 kg/ m2 ). The first assistant′right hand holded suction device and left hand holded intestinal clamp to expose the operation field,absorbed the gas and liquid and provide a good operation field in time during the lymph node dissection of the main supply blood vessels around the stomach. The operation time was(135 ± 30)min(100-180 min). The amount of bleeding during operation was(100 ± 50)ml(50-200 ml). Conversion laparotomy rate was 2. 15% . No serious complications oc-curred during the operation. Conclusion During the laparoscopic radical gastrectomy for gastric cancer, especially for overweight and obese patients,the first assistant skillfully use aspirator to draw,pull,strip and using other functions,which can provide a good surgical field,reducing the difficulty of operation,ef-fective controlling of bleeding,shorting operation time,and reducing the rate of conversion laparotomy.