腹腔镜辅助下根治性胃切除术17例临床初步报告

目的探讨腹腔镜辅助下根治性胃切除术的可行性、方法和效果.方法 17例胃癌病人行腹腔镜辅助下根治性胃切除术,其中根治性全胃切除术3例,近端胃大部切除术4例,远端胃大部切除术10例.结果 17例中,除2例中转开腹外,其余15例均成功进行腹腔镜手术.手术平均用时:全胃切除401 min(340～475 min),近端胃切除254.3 min(212～340 min),远端胃切除324.5 min(270～377 min).术中平均出血量:全胃切除650 ml(400～900 ml),近端胃切除125 ml(50～200 ml),远端胃切除125 ml(100～200 ml),平均清扫淋巴结15.17枚(8～41枚).术后病人平均胃肠功能恢复时间3.4 d (2～5 d),下床活动时间3.5 d(2～5 d),进流质时间4.5 d(3～6 d),术后近期效果良好.无1例手术并发症.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.

Laparoscope-assisted radical gastrectomy

Objective To explore the feasibility, method, and clinical outcomes of laparoscope-assisted radical gastrectomy. Methods Laparoscope-assisted gastrectomy was performed in 17 cases of gastric cancer, including radical total gastrectomy in 3 cases, proximal gastrectomy in 4 cases, and distal gastrectomy in 10 cases. Results Laparoscope-assisted surgery was successfully performed in 15 cases. There was only 2 cases converted to abdominal opening. The average operative time for total gastrectomy, proximal gastrectomy, and distal gastrectomy was 401 min (340-475 min), 254.3 min (212-340 min), and 324.5 min (270-377 min), respectively. The average blood loss in total gastrectomy, proximal gastrectomy, and distal gastrectomy was 650 ml (400-900 ml), 125 ml (50- 200 ml) , and 125 ml (100-200 ml), respectively. The average number of dissected lymph nodes was 15.17 (8-41). The average time for gastrointestinal function recovery, for the patients to stand up, and for the start of oral liquids was 3.4 d (2nd-5th day), 3.5 d (2nd-5th day), and 4.5 d (3rd-6th day) after operation, respectively. The postoperative outcomes were satisfactory. No complications were found. Conclusion Laparoscope-assisted radical gastrectomy is safe, feasible, and minimally invasive and can achieve the same result of abdominal opening.