腹腔镜下进展期远端胃癌D2根治术疗效分析  

Effective analysis of Laparoscopy-assisted D2 redical gastrectomy for Staging distal Gastric cancer

作　　者：刘世强[1] 区小卫[1] 张少锐[1] 黄文[1] 

机构地区：[1]佛山市第二人民医院甲状腺,胃肠外科,广东佛山528000

出　　处：《医学信息（中旬刊）》2011年第7期3222-3223,共2页Medical Information Operations Sciences Fascicule

摘　　要：目的:探讨腹腔镜下进展期远端胃癌D2根治术的安全性及可行性。方法:对我院2010年1～11月14例进展期远端胃癌行腹腔镜下D2根治术,其中毕Ⅰ式13例,毕Ⅱ式1例,清扫1、3、4、5、6、7、8a、9、11p、12a组淋巴结;所有患者均于上腹部做辅助小切口行病灶移除及消化道重建。结果:14例均顺利完成腹腔镜下胃癌D2根治手术,无中转开腹,手术用时(170～300)min,平均225.4min,清扫淋巴结(15～63)枚/例,平均32.33枚/例,术中出血量(50～300)ml,平均150ml;术后患者平均胃肠功能恢复时间(2±1)d,下床活动时间(2±0.5)d,进流质时间(2±1)d。术后1例标本切缘阳性,余均为阴性。无吻合口漏等手术相关并发症。14例随访6个月,13例未见复发和转移,1例吻合口复发,全部未发生切口和穿刺口种植。结论:腹腔镜进展期远端胃癌D2根治术安全、可行,能够达到与开腹手术相当的根治效果,具有创伤小,术后恢复快等优点。Objective：To investigate the feasibility and safety of laparoscopy - assisted D2 redical gastrectomy for Staging distal Gastric cancer. Methods：From January 2010 to November 2010, a series of 14 patients with staging distal gastric cancer underwent laparoscopy - assisted D2 radical gastrectomy in our hospital. Among them Billroth Ⅰ operation in 13 case,Billroth Ⅱ operation in 1 case. For distal gastrectomy,groups 1,3,4,5,6,7,Sa,9,11p,12a lymph nodeswere resected,Reconstruction of the digestive tractwas performed after the resected tumorwas removed through a mini - incision on the upper abdomen. Restllts：The procedure was completed in all of the patients without conversion to open surgery. The mean operation time was （ 170- 300 ） min, （ mean ,225 ）. The mean numbers of harvested lymph nodes were （ 15 -63 ） , （ mean ,32.33 ）. The mean volume of blood loss was （50 - 300） ml, （mean,150）. The mean time was （2 - 1 ）d for gastrointestinal function recovery, （2 -0.5） d for patients＇ taking general activity, （ 2 - 1 ） d for taking liquid food. Postoperative pathological examination showed that the edge of the resected samples was positive in 1 case, negative in the others. No patient had anastomotie leakage or other complications. All of the cases were followed up 6 months. During the period, no recurrence and metastasis in 13 cases, 1 case recurre, or implantations at the incision or puncture sites were found in all case. Conclusion： Laparoscopy - assisted D2 redieal gastrectomy for Staging distal Gastric cancer is a safe,feasible and minimally invasive treatment and can achieve the same outcomes as the open operation.

关 键 词：腹腔镜 进展期远端胃癌 根治术 

分 类 号：R735.2[医药卫生—肿瘤]