腹腔镜进展期胃癌根治术66例报告  

Laparoscopic Radical Resection for Advanced Gastric Cancer:Report of 66 Cases

作　　者：李栋[1] 周旭坤[2] 李平[1] 江涛[1] 罗毅[1] 李忠[1] 刘顺顺[1] 吴梅青[1] 

机构地区：[1]新疆兵团农一师医院普外科,阿克苏843000 [2]新疆兵团医院普外科,乌鲁木齐830002

出　　处：《中国微创外科杂志》2011年第9期773-775,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：新疆生产建设兵团科技攻关项目(2009GG55)

摘　　要：目的探讨腹腔镜进展期胃癌根治术的安全性及可行性。方法 2006年4月-2010年6月对66例进展期胃癌行腹腔镜胃癌根治术,其中远端胃癌根治性切除术41例;近端胃癌根治性切除术22例,全胃癌根治性切除术3例。结果 66例手术均获成功。手术时间：远端胃癌根治术平均280 min（220-340 min）;近端胃癌根治术平均269 min（215-325min）;3例根治性全胃切除术手术时间分别为340、370、410 min。平均切口长度6.0 cm（5.2-9.0 cm）。术中出血量：腹腔镜远端胃癌根治术平均160 ml（100-250 ml）,腹腔镜近端胃癌根治术平均200 ml（90-320 ml）,3例腹腔镜根治性全胃切除术出血量分别为200、350、400 ml。清扫淋巴结：远端胃癌根治术平均21枚（15-31枚）,近端胃癌根治术平均22枚（17-28枚）,3例根治性全胃切除术分别为25、29、35枚。65例术后随访3-48个月,平均20个月（〈1年21例,1-2年19例,〉2年25例）,均未见切口及戳孔肿瘤种植转移;1例ⅢB期术后1年出现腹腔种植转移后死亡,1例ⅢB期术后1年出现肝转移后死亡,其余患者均健在。结论腹腔镜进展期胃癌根治术安全可行,能够取得良好的近期疗效。Objective To explore the safety and feasibility of laparoscopic radical resection for patients with advanced gastric cancer.Methods Totally 66 patients with advanced gastric cancer received radical resection by laparoscopy in our hospital from April 2006 to June 2010.Among the cases,resection of distal gastric cancer was performed in 41 cases,and that of proximal gastric cancer in 22 cases,total resection of gastric cancer was carried out in 3 cases.Results The procedures were completed in all the 66 cases within a mean operation time of 280（220-340） min for radical resection of distal gastric cancer,269（215-325） min for radical resection of proximal gastric cancer,and 340,370,and 410 min respectively for the 3 cases of radical total gastrectomy.The average incision length was 6.0 cm（5.2-9.0 cm）.The mean blood loss was 160 ml（100-250 ml） in distal gastrectomy,200 ml（90-320 ml） in proximal gastrectomy,and 200,350,and 400 ml respectively in the 3 cases of laparoscopic radical total gastrectomy.The mean number of removed lymph nodes was 21（15-31） in distal gastrectomy,22（17-28） in proximal gastrectomy,and 25,29,35 respectively in the 3 cases of radical total gastrectomy.After the surgery,65 patients were followed up for 3 to 48 months（1 year in 21 cases,1 to 2 years in 19 cases,and 2 years in 25 cases）,all the patients showed no tumor inplantation nor metastasis to the imcision and puncture sites.Two ⅢB cases died of abdominal implantation or liver metastasis in one year after operation.Conclusions Laparoscopic radical operation is safe and feasible for advanced gastric cancer with obvious good short-term efficacy.

关 键 词：腹腔镜 进展期胃癌 胃癌根治术 

分 类 号：R735.2[医药卫生—肿瘤]