腹腔镜辅助下胃癌D2根治术的临床研究  

Laparoscopy-assisted D2 radical gastrectomy for gastric cancer： a clinical report of 42 cases

作　　者：杜晓辉[1] 李荣[1] 陈凛[1] 田文[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：《中华普通外科杂志》2008年第1期5-7,共3页Chinese 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胃癌D2根治术的手术方法、可行性及临床效果。方法回顾性分析我院2004年6月-2007年6月行腹腔镜辅助下胃癌D2根治术42例患者的临床资料。结果本组42例均行腹腔镜辅助下胃癌D2根治术，其中远端胃大部切除术20例，近端胃大部切除术15例，全胃切除术7例，无中转开腹，无手术死亡。平均手术时间：远端胃大部切除术（285±60）min，近端胃大部切除术（178±62）min，全胃切除术（323±86）min；术中平均出血量：远端胃大部切除术（140±52）ml，近端胃大部切除术（196±85）ml，全胃切除术（234±76）ml；淋巴结清扫12—40枚，平均（25±10）枚；术后患者平均胃肠道功能恢复时间75h。术后随访1～36个月，平均9．7个月，2例十二指肠残端瘘行保守治疗痊愈。结论对早期及部分进展期胃癌行腹腔镜辅助下胃癌D2根治术技术可行，同时具备创伤小、恢复快、出血少等优点。Objective To evaluate the method, feasibility and the clinical result of laparoscopy-assisted radical gastrectomy with D2 regional lymphadenectomy. Methods The clinical data of 42 cases of laparoscopy-assisted D2 radical gastrectomy were analyzed retrospectively. Results Laparoscopy-assisted radical D2 gastrectomy was performed in 42 cases including distal gastrcetomy in 20 cases, proximal gastrectomy in 15 cases and total gastrectomy in 7 cases. There was no conversion to open surgery and no postoperative mortality. The mean operation time was （285 ± 60）min for distal gastrectomy, （178 ± 62）min for proximal gastrectomy and （323 ± 86 ）min for total gastrectomy. The average blood loss for distal gastrectomy, proximal gastrectomy, total gastrectomy was （ 140 ± 52） ml, （ 196 ± 85 ） ml and （ 234 ± 76） ml, respectively. The average number of lymph nodes dissected was （25 ± 10 ）. The average time for gastrointestinal function recovery was 75 hrs. Duodenal stump fistula in 2 cases was cured by conservative therapy. Conclusions Laparoscopy-assisted D2 radical gastrectomy for early and advanced gastric cancer is feasible, safe, and minimally invasive.

关 键 词：胃肿瘤 腹腔镜检查 胃切除术 

分 类 号：R686[医药卫生—骨科学]