腹腔镜辅助胃癌根治术83例临床分析  

Laparoscopy-assisted radical gastrectomy:clinical analysis of 83 cases

作　　者：贺海斌[1] 严志龙[1] 沈迎春[1] 

机构地区：[1]浙江宁波市医疗中心李惠利医院普通外科,宁波315040

出　　处：《消化肿瘤杂志（电子版）》2011年第3期164-166,共3页Journal of Digestive Oncology(Electronic Version)

摘　　要：目的探讨腹腔镜辅助胃癌根治术在胃癌治疗中的临床应用。方法回顾性分析总结2010年7月至2011年8月间我院施行腹腔镜辅助胃癌根治术83例患者的临床资料,包括手术方式、手术时间、术中失血、术后排气时间、术后住院天数、并发症、术后病理和随访结果等。结果除2例中转开腹手术外,其余81例均在腹腔镜下完成胃切除和D2淋巴结清扫,其中腹腔镜辅助远端胃切除70例,全胃切除11例。手术时间为(173.5±60.5)min,术中失血(101.5±89.5)ml,患者术后排气时间(2.3±1.0)d,术后住院时间为(9.3±4.5)d。术后发生吻合口瘘1例(1.20%)、术后胃瘫综合征4例(4.82%)。手术平均清扫淋巴结(22.3±8.4)枚。术后随访1～13个月,未见肿瘤复发和远处转移。结论腹腔镜辅助胃癌根治术安全、可行,围手术期及近期疗效有优势。Objective To investigate the clinical application of laparoscopy-assisted radical gastrectomy for gastric cancer.Methods Clinical data of 83 gastric cancer patients undergoing laparoscopy-assisted radical gastrectomy in our hospital from July 2010 to August 2011 were retrospectively reviewed and analyzed for surgical procedures,operating time,blood loss,time to passage of flatus,post-operative hospital stay,complications,pathology and follow-up.Results Laparoscopy-assisted gastrectomy and D2 lymph nodes dissection were successfully performed in all except 2 patients with conversion to open surgery because of intraoperative bleeding,including distal subtotal gastrectomy in 70 cases,and total gastrectomy in 11cases.The mean operating time was(173.5±60.5) min,mean blood loss was(101.5±89.5)ml,mean time to passage of flatus was(2.3±1.0) d and mean post-operative hospital stay was(9.3±4.5)d.Anastomotic leakage occurred in 1 patient(1.20%),and postsurgical gastroparesis syndrome in 4 patients(4.82%).The mean number of dissected lymph nodes was(22.3±8.4).There was no tumor recurrence or metastasis after follow-up from one to 13 months.Conclusion Laparoscopy-assisted radical gastrectomy is safe and feasible with advantages of minimal invasiveness and short-term efficacy.

关 键 词：胃癌 腹腔镜 根治手术 并发症 

分 类 号：R735.2[医药卫生—肿瘤]