手助腹腔镜胃癌D_2根治术100例报告  

Hand-assisted laparoscopic D_2 radical gastrectomy:a report of 100 cases

作　　者：曹永宽[1] 刘立业[1] 王永华[1] 龚加庆[1] 周均[1] 罗国德[1] 黄玲[1] 干伟[1] 

机构地区：[1]成都军区总医院全军普外中心胃肠外科,四川成都610083

出　　处：《中国普通外科杂志》2013年第10期1257-1260,共4页China Journal of General Surgery

摘　　要：目的：初步评价手助腹腔镜胃癌根治术的近期疗效。方法：回顾性分析2010年12月-2012年7月完成的手助腹腔镜胃癌根治术100例患者的临床资料和随访记录。结果：实施手助腹腔镜胃癌根治术102例，中转开腹2例（1．96％）。成功完成手术100例，全胃切除术53例，远端胃切除术39例，近端胃切除术8例；联合胆囊切除术4例，联合左肝外叶部分切除术2例，联合胰体尾部分切除＋脾切除术1例。平均手术切口长度（6．81±0．29）cm：术中出血量（244．10±117．02）mL；手术时间（172．28±24．02）min；病理检获淋巴结数（17．10±5．70）枚；术后住院时间（10．20±3．84）d。无围手术期死亡，手术相关并发症率9％（9／100）。术后随访时间1-12个月，失访率6％（6／100），同时性肝转移3例，异时性淋巴结转移1例，局部复发1例。结论：手助腹腔镜胃癌D2根治术安全、可靠，近期疗效良好，且并不会增加肿瘤在腹腔转移的机会。Objective： To make a preliminary evaluation for the short-term efficacy of hand-assisted laparoscopic radical gastrectomy. Methods： The clinical and follow-up records of 100 stomach cancer patients undergoing hand-assisted laparoscopic radical gastrectomy from December 2010 to July 2012 were retrospectively analyzed. Results： Hand-assisted laparoscopic radical gastrectomy was performed in 102 patients, of whom 100 cases were completed successfully and two cases （1.96%） were converted to open procedure. Among the i00 laparoscopic patients, gastrectomy was performed in 53 cases, distal gastrectomy in39 cases, and proximal gastrectomy in 8 cases; 4 cases underwent combined cholecystectom）5 2 cases underwent combined partial resection of the left lateral lobe, and one case underwent combined splenectomy plus resection of pancreatic body and tail. The average length of incision was （6.81±0.29） cm, blood loss was （244.10±117.02） mL,operative time was （172.28±24.02） rain, number of lymph nodes obtained for pathological examination was 17.10±5.70, and length of postoperative hospital stay was （10.20±3.84） d, respectively. No perioperative death occurred and the incidence of postoperative complications was 9% （9/100）. The postoperative follow- up period ranged from one month to 12 months, and 6 cases （6%） were lost to follow-up. Simultaneous liver metastases were found in 3 cases, heterochronic lymph node metastasis occurred in one case, and local recurrence developed in one case, respectively. Conclusion： Hand-assisted laparoscopic Dz radical surgery for gastric cancer is safe and reliable with favorable short-term outcome, and it may not increase the chance ofintra-abdominal metastases.

关 键 词：胃肿瘤 外科学 胃切除术 腹腔镜 手辅助 

分 类 号：R735.2[医药卫生—肿瘤]