中间入路腹腔镜下进展期胃癌D2术62例分析  

Laparoscopic-assisted radical gastrectomy with a medial-to-lateral approach for advanced gastric carcinoma and D2 lymphadenectomy

作　　者：王道荣[1,2] 鱼海峰[1,2] 赵建国[1,2] 汤东[1,2] 赵勇[1,2] 郭凯[1,2] 赵泽坤[1,2] 汪刘华[1,2] 李永坤[1,2] 

机构地区：[1]扬州大学临床医学院 [2]江苏苏北人民医院胃肠外科,225001

出　　处：《中华普外科手术学杂志（电子版）》2010年第2期26-29,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨中间入路腹腔镜辅助下进展期胃癌根治术的临床应用与疗效。方法分析临床中间入路腹腔镜辅助下进展期胃癌根治术的62例患者,包括根治性全胃切除术11例,近端胃大部切除术27例,远端胃大部切除术24例。结果62例患者都成功实施中间入路腹腔镜胃癌根治术。手术平均时间：全胃切除术平均230 min,远、近端胃切除术平均198min。术中平均出血量：全胃根治性切除术218 ml,远、近端胃根治性切除术132 ml,术中平均淋巴结清扫：全胃根治性切除术22枚,远、近端胃根治性切除术19.6枚。排气时间平均48 h;进流食时间平均4.8 d。术中均未输血,随访1~45个月。62例患者均未见腹腔肿瘤复发和转移,亦未发生切口肿瘤和穿刺口肿瘤种植转移（简称：切口种植）。结论中间入路腹腔镜辅助下进展期胃癌根治术安全、可行,比传统腹腔镜辅助下胃癌根治术操作简单、易行,具有广阔的应用前景。Objective To investigate the clinical application and curative effect of laparoscopic-assisted radical gastrectomy by the medial-to-lateral approach.Methods We analysed 62 patients who had undergone laparoscopic-assisted radical gastrectomy by the medial-to-lateral approach.Of these patients,11 received radical total gastrectomy,27 proximal gastrectomy,and 24 distal gastrectomy.Results Sixty-two patients underwent laparoscopic-assisted surgery by the medial-to-lateral approach successfully.The average operative time was 230 minutes for total gastrectomy and 198 minutes for proximal gastrectomy and distal gastrectomy.The average blood loss was 218 ml during total gastrectomy and 132 ml during proximal gastrectomy and distal gastrectomy.The average member of lymph nodes cleansed was 22 in total gastrectomy and 19.6 in proximal gastrectomy and distal gastrectomy respectively.The average time for gas exhasting was 48 hours and the average water inlet time was 4.8 days.No blood was transfused during the operation.Follow-up varied from 1 to 45 months.All of the 62 patients had no recurrence and metastasis nor planting of gastric cancer at the sites of incision and puncture.Conclusions Laparoscopic-assisted radical gastrectomy by the medial-to-lateral approach for advanced stomach carcinoma is safe and feasible.It is easier to perform than the traditional laparoscopic-assisted operation.

关 键 词：腹腔镜检查 胃肿瘤 肿瘤转移胃切除术 淋巴结切除术 

分 类 号：R735.2[医药卫生—肿瘤]