腹腔镜胃癌根治术的初步应用

目的:探讨腹腔镜胃癌根治术的可行性。方法:2008年8月～2009年6月我院完成腹腔镜胃癌根治术10例,对其临床资料进行回顾性分析。结果:10例全部在腹腔镜下成功完成胃的游离及淋巴结的清扫;其中全胃切除1例,近端胃大部切除1例,远端胃大部切除8例。手术时间160～380min;术中出血量80～300ml。所有标本切缘均阴性;清扫淋巴结16～42枚。术后患者胃肠功能恢复时间2～3d,下床活动时间3～4d。本组病例未出现吻合口漏、切口感染等并发症;1例出现横结肠瘘,再次手术治愈。10例术后均获随访,随访时间6～16个月,无局部复发及穿刺孔种植转移。结论:经过选择的胃癌病人行腹腔镜胃癌根治术安全可行,术中要严格遵循无瘤原则。

Clinical application of laparoscopic gastrectomy

Objective：To explore the feasibility of laparoscopic gastrectomy（LG） for gastric cancer.Methods：We performed LG in 10 patients with gastric cancer in our hospital between Aug.2008 and Jun.2009 and the clinical data were reviewed.Results：The total 10 patients were undergone mobilization of stomach and dissection of lymph nodes under laparoscope,among whom 1 underwent total gastrectomy,1 proximal partial and 8,distal partial gastrectomy.The operation duration ranged from 160 to 380 min,and intraoperative blood loss was from 80 to 300ml.No case had residual tumor in incision margin and the numbers of harvested lymph nodes were between 16 and 42.The gastrointestinal function recovered in 2 to 3 and out-of-bed activity was in 3 to 4 d.No incidence of postoperative stomal leak,wound infection or complications occurred except for transverse colon fistula development in 1case that required re-operation.Follow-up of the 10 patients between 6 and 16 months showed no recurrence or port-site metastasis.Conclusion：LG is safe and feasible for the selected patients with gastric cancer,but strictly,residual tumor should be free during the procedure.