同术者同期内腹腔镜与开腹远端胃癌D2根治术的对比研究  

Comparison of laparoscopic D2 radical distal gastrectomy and open surgery for advanced gastric cancer

作　　者：胡炳仁[1] 蒋飞照[1] 朱恒梁[1] 叶百亮[1] 阮小蛟[1] 屠金夫[1] 尤和谊[1] 周振旭[1] 张维建[1] 蔡华杰[1] 

机构地区：[1]温州医学院附属第一医院腔镜外科,浙江温州325000

出　　处：《中国内镜杂志》2012年第6期566-570,共5页China Journal of Endoscopy

摘　　要：目的探讨腹腔镜辅助进展期远端胃癌D2根治术的手术安全性及手术技巧。方法回顾性对比分析同一术者、同时期内腹腔镜(28例)和开腹(30例)进展期远端胃癌D2根治术的手术时间、术中出血量、淋巴结清扫数目、围手术期并发症发生率、术后恢复情况等指标,总结手术方法和技巧。结果所有腹腔镜组手术均获成功实施,手术时间、淋巴结清扫数目与开腹手术相当,术中出血、术后切口感染发生率少于开腹手术,肠功能恢复时间,进食流质时间及住院时间短于开腹手术。结论沿正确的筋膜间隙进行解剖、规范化淋巴结清扫、熟练的器械操作,能使腹腔镜进展期远端胃癌D2根治术安全可行,肿瘤根治性与开腹手术相当,围手术并发症发生情况及术后恢复优于开腹手术。[Objectivel To discuss the safety and the surgical techniques of laparoscopy-assisted D2 radical distal gastrectomy for advanced gastric cancer. [ Methods ] Data of same surgeon at the same period for 28 patients who underwent laparoscopy-assisted D2 radical distal gastrectomy and 30 patients who underwent open surgery were collected and analyzed retrospectively. The operation time, intraoperative blood loss, the number of lymph node har- vest, perioperative complications, postoperative recovery were compared between two groups. Furthermore, the surgi- cal methods and techniques were summarized. [ Results ] The operations were all performed successfully in laparo- scopic surgery group. The operation time, and the number of lymph node harvest was equivalent in the two groups, but the intraoperative blood loss, postoperative rate of infection and singuhus in laparoscopic surgery group were sig- nificantly less than those in open surgery group, and time of bowel movement return, time of taking liquid food and hospitalization days were shorter than those in open surgery group. [Conclusions] Anatomise from the correct anatomical space and fascia levels in operation, emphasized regular lymph node dissection, laparoscopy-assisted D2 radical distal gastrectomy can be carried out safely and effectively and strictly follow the principles of surgical oncol- ogy for advanced gastric cancer. It showed more great advantages compared with the open surgery.

关 键 词：胃肿瘤 胃切除 腹腔镜 

分 类 号：R735.2[医药卫生—肿瘤]