腹腔镜近端胃大部切除7例体会

目的:探讨腹腔镜近端胃大部切除的方法、效果及可行性。方法:回顾分析腹腔镜胃大部切除7例的临床资料。结果:7例均在腹腔镜下成功完成手术,平均用时278m in(237~356m in),术中平均出血量120m l(60~300m l),病理检查低分化腺癌4例,中分化腺癌2例,高分化腺癌1例,均未见残端肿瘤残余,切缘距肿瘤边缘5.9 cm(3.5~8.5 cm),平均清扫淋巴结14.2个(7~21个)。术后患者第1次排气时间34.2h(18~69h),第1次离床活动时间42.7h(38~77h),术后24h即鼓励患者少量喝水,未出现腹胀或呕吐。术后平均住院8.4d(7~11d),未进行化疗,随访2~13月,无复发。结论:腹腔镜近端胃大部切除术安全、可行,能够达到与开腹手术相当的根治效果,具有患者创伤小,术后康复快等优点。

Laparoscopic proximal gastrectomy: a report of 7 cases

Objective:To explore the method,effect and feasibility of laparoscopic proximal gastrectomy.Methods:The clinical data of seven cases were analyzed retrospectivecy.Results:All cases were operated with laparoscopic method successfully.The mean operative time was 278min(237-356min).The mean blood loss was 120ml(60-300ml).Pathology results included 4 cases of low differential adenoma,2 cases of middle differential adenoma and 1 case of high differential adenoma.The mean distance from incision edge to the tumour was 5.9cm(3.5-8.5cm).The mean number of lymph nodes dissected was 14.2(7-21).Time of bowel pass was 34.2h(18-69h).Time of bedside movement was 42.7h(38-77h).Patients were encouraged to drink water 24h after operation,no vomitting was observed.The mean hospitalization was 8.4d(7-11d).No recurrence was observed during the 2-13 months follow-up.Conclusions:Laparoscopic proximal gastrectomy is a safe procedure and matches the results of open operation.It has the merits of less trauma and rapid recovery.