腹腔镜辅助胃底贲门癌根治术:附22例报告  

Laparoscopy-assisted radical proximal gastrectomy for gastric cancer:a report of 22 cases

作　　者：杜晓辉[1] 李荣[1] 陈凛[1] 郭强[1] 张小杰[1] 陈亮[1] 

机构地区：[1]解放军总医院普通外科,北京100853

出　　处：《中国普通外科杂志》2007年第12期1137-1139,共3页China Journal of General Surgery

基　　金：国家自然科学基金资助项目(60601018);北京市科技新星计划资助项目(2006A51);军队"十五"计划医学科研重点课题(04Z019)

摘　　要：目的探讨腹腔镜辅助下行D2式胃底贲门癌根治术的临床效果。方法回顾性分析3年间行腹腔镜辅助下胃底贲门癌根治术22例患者的临床资料。全组均行腹腔镜辅助下近端胃大部切除术。结果无中转开腹，平均手术时间188（162～270）min。术中平均出血182（100～260）mL。淋巴结清扫18．6（10～32）枚。术后患者平均胃肠道功能恢复时间78（48～140）h。1例肿瘤侵犯食管下段的患者术后发生吻合口瘘，经留置空肠营养管、抗炎、充分引流等处理后4周痊愈。无手术死亡。全组术后随访1—37个月，平均9．2个月，无复发转移病例。结论腹腔镜辅助下行D2式胃底贲门癌根治术方法可行，效果好，具有视野清晰、创伤小、出血少、恢复快等优点。Objective To explore the clinical efficacy of laparoscopy-assisted radical D2 proximal gastrectomy. Methods The clinical data of 22 cases of laparoscopy-assisted D2 radical proximal gastrectomy were analysed retrospectively. Results Laparoscopy-assisted radical proximal gastrectomy was carried out in all of the 22 cases. There was no conversion to open surgery in this series. The mean operation time was 188 （162 -270） min. The mean operative blood loss was 182（ 100 - 260）mL. The number of lymph nodes dissected was 18.6（ 10 - 32）. The average time for gastrointestinal function recovery was 78 （48 - 140 ） h. Postoperative anastomotic leakage occurred in one patient who had tumor invasion of distal esophagus, and it healed after 4 weeks of conservative treatment. There were no postoperative deaths in this series. All the 22 cases were followed up for 1 - 37 months （ mean 9.2 months ） and revealed no recurrence or metastasis. Conclusions Laparoscopy-assisted radical D2 proximal gastrectomy for early and advanced gastric cancer is feasible, safe, and minimally invasive.

关 键 词：腹腔镜 胃肿瘤/外科学 胃底 贲门 胃切除术 

分 类 号：R735.5[医药卫生—肿瘤]