腹腔镜辅助胃癌根治术治疗胃癌的临床评价  

Laparoscopic assisted gastrectomy for gastric cancer

作　　者：谢雪蒙[1] 牟一平[1] 严加费[1] 徐晓武[1] 陈其龙[1] 陈灵华[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院普外科,浙江大学微创外科研究所,浙江杭州310016

出　　处：《全科医学临床与教育》2010年第3期245-247,259,共4页Clinical Education of General Practice

基　　金：浙江省教育厅科研项目(Y200803722)

摘　　要：目的总结腹腔镜辅助胃癌根治术的临床经验。方法回顾性分析行腹腔镜辅助胃癌根治术68例患者的临床资料,并作随访。结果 68例手术均顺利完成,其中根治性全胃切除13例,根治性近端胃大部切除6例,根治性远端胃大部切除49例。手术时间200～420min,平均(292.26±50.31)min;术中出血50～400ml,平均(152.32±90.28)ml;切口长度4.8～6.5cm,平均(5.61±0.74)cm。淋巴结清扫数目13～48个,平均数(30.62±9.54)个,中位数27个。所有切缘均为阴性,近端切缘为2.5～13cm,平均(6.42±2.13)cm;远端切缘为2.1～11cm,平均(6.25±1.90)cm。术后肛门排气时间2～6d,平均(3.70±1.16)d;术后住院时间5～19d,平均(8.74±3.01)d,中位时间8d。结论腹腔镜辅助胃癌根治术是安全可行的,能达到肿瘤根治的要求,具有创伤小、出血少、恢复快等优点,可应用于早期胃癌及部分病灶局限、无远处转移的进展期胃癌。Objective To summary the experience of laparoscopic assisted radical gastrectomy. Methods Clinical data of 68 cases who suffered from gastric cancer and received laparoscopic assisted radical gastrectomy were analyzed retrospectively. Results All patients underwent laparoscopic-assisted gastrectomy successfully, including laparoscopic-assisted distal gastrectomy for 49 cases, laparoscopic-assisted total gastrectomy for 13 cases, laparoscopic-assisted proximal gastrectomy for 6 cases. The average operative time was （292.26±50.31） min （range from 200 to 420 min）. The average blood loss was （152.32±90.28）ml （range from 50 to 400 ml）.The average incision length was （5.61±0.74） cm （range from 4.8 to 6.5 cm）. The average number of nodes cleaned was （30.62±9.54） （range from 13 to 48, median number 27）. All the margins were free of tumor on pathology. The average proximal margin was （6.42±2.13） cm, and the average distal margin was（6.25±1.90） cm. The average time of the first flatus was （3.70± 1.16） d （range from 2 to 6 d）. The average postoperative hospital stay was （8.74±3.01） d （range from 5 to 19 d, with the median time 8 d）. Conclusions The laparoscopic-assisted gastrectomy for gastric cancer is a safe, feasible procedure. It has the advantages of minimal invasive, faster recovery, and shorter hospital stay.

关 键 词：腹腔镜手术 胃切除术 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]