腹腔镜老年胃癌根治术49例治疗体会  

The experience and perioperative management for the resection of laparoscopic gastrectomy for the aged gastric carcinoma

作　　者：鲁明[1] 喻春钊[1] 张弛[1] 汪宝林[1] 赵庆洪[1] 

机构地区：[1]南京医科大学附属第二医院普外科,210011

出　　处：《中国现代医药杂志》2011年第10期20-22,共3页Modern Medicine Journal of China

摘　　要：目的探讨腹腔镜老年胃癌根治术的安全性、可行性及围术期处理经验。方法回顾性分析我院2008年6月～2011年6月70岁以上接受腹腔镜胃癌根治术的患者49例。结果 49例均在腹腔镜下完成手术,无中转开腹,平均手术时间273min(180～400min),平均术中出血量158ml(50～450ml),平均清扫淋巴结17.6枚(7～51枚),术后平均排气时间3.5d(2～6d)。术后转入ICU15例(30.6%),平均术后住院天数14天。术后8例(16.3%)伴有不同程度的并发症,无切口感染、切口裂开、吻合口漏,肺部感染6例,心律失常1例,残胃排空障碍1例。术后死亡1例(2.0%),死于肺部感染、急性呼吸功能衰竭。结论腹腔镜老年胃癌根治术安全、可行。加强对其围手术期处理可提高腹腔镜老年胃癌根治术的安全性。Objective To explore the feasible,safe and perioperative management for the resection of laparoscopic gastrectomy for the aged gastric carcinoma. Methods From Jun 2008 to Jun 2011 ,the experience of the resection of laparoscopic gastrectomy for the aged gastric carcinoma in 49 patients over 70 years old were analyzed retrospectively. Results There was no conversion to open surgery,mean operative time was 273min（180-400min）,intraoperative blood loss 158ml（50-：450ml）,the mean number of lymph nodes harvested 17.6 nodes （7-51nodes）,the average time of recovery of gastrointestinal function after surgery was 3.Sd（2-6d）,15 patients （30.6%） transferred to ICU,mean postoperative hospital stay was 14d.Postoperative complications：the coexisting diseases included cardiac arrhythmias （1 case）,lung infection （6 cases）, functionality delayed gastric emptying （FDGE 1 case）, no wound infection, no wound dehiscence, no anastomotic fistula. One case （2.0%） died postoperatively of lung infection and acute respiratory failure. Conclusion Intensive perioperative management of the coexisting diseases can increase the security of operation.Laparoscopic gastrectomy is feasible and safe for elderly patients with gastric carcinoma.

关 键 词：胃癌 老年人 腹腔镜 围手术期 

分 类 号：R735.2[医药卫生—肿瘤]