腹腔镜胃手术的临床应用

目的 探讨经腹腕镜胃手术的临床价值。方法 １９９２年１２月至１９９９年１月应用腹腔镜技术治疗胃疾病患者６１例。年龄２９．０￣７８．０岁,平均５７．４岁。其中Ｂ－Ⅱ式胃大部切除术１７例,Ｂ－Ⅰ式胃大部切除术１例,近端胃次全切除术２例,高选择性迷走神经切除术５例,胃造瘘术３例,胃壁良性肿瘤切除术３３例。５４例手术完全在腹腔镜下进行在腹腔镜下进行（８８．５％）,７例行腹腔镜辅助下胃手术（１１．５％）。结

Laparoscopic gastric resection

OBJECTIVE: To modify laparoscopic surgery for gastric diseases. METHODS: From December 1992 to January 1999, 61 gastric laparoscopic operations were performed in our hospital. The age of the patients ranged from 29 to 78 years (mean 57.4). 17 patients had Billroth II gastrectomy, 1 Billroth I gastrectomy, 2 proximal subtotal gastrectomy, 5 highly selective vagotomy, 3 gastrostomy, and 33 resection of gastric submucosal benign tumor. 54 patients (88.5%) underwent complete laparoscopy, and 7 (11.5%) an assisted one RESULTS: The mean operative time was (164.2 +/- 93.5) min, the mean estimated blood loss was (218.3 +/- 166.6) ml, and the mean hospital stay was (6.8 +/- 2.1) days. Flatus was present within 48 hours in 86% of the patients. Two patients had laparoscopic surgery for early gastric cancer, and were followed up for more than 55 months. Postoperative complication were noted in 2 patients, who were cured by reoperation and endoscopy therapy respectively. Only 4 patients required postoperative analgesics. CONCLUSION: Although specific indications need to be defined, laparoscopic surgery is feasible. But long-term follow-up should be made to evaluate its efficacy in treatment of gastric cancer.