摘要
目的探讨腹腔镜辅助下胃癌D2根治术的手术方法、可行性及临床效果。方法回顾性分析我院2004年6月-2007年6月行腹腔镜辅助下胃癌D2根治术42例患者的临床资料。结果本组42例均行腹腔镜辅助下胃癌D2根治术,其中远端胃大部切除术20例,近端胃大部切除术15例,全胃切除术7例,无中转开腹,无手术死亡。平均手术时间:远端胃大部切除术(285±60)min,近端胃大部切除术(178±62)min,全胃切除术(323±86)min;术中平均出血量:远端胃大部切除术(140±52)ml,近端胃大部切除术(196±85)ml,全胃切除术(234±76)ml;淋巴结清扫12—40枚,平均(25±10)枚;术后患者平均胃肠道功能恢复时间75h。术后随访1~36个月,平均9.7个月,2例十二指肠残端瘘行保守治疗痊愈。结论对早期及部分进展期胃癌行腹腔镜辅助下胃癌D2根治术技术可行,同时具备创伤小、恢复快、出血少等优点。
Objective To evaluate the method, feasibility and the clinical result of laparoscopy-assisted radical gastrectomy with D2 regional lymphadenectomy. Methods The clinical data of 42 cases of laparoscopy-assisted D2 radical gastrectomy were analyzed retrospectively. Results Laparoscopy-assisted radical D2 gastrectomy was performed in 42 cases including distal gastrcetomy in 20 cases, proximal gastrectomy in 15 cases and total gastrectomy in 7 cases. There was no conversion to open surgery and no postoperative mortality. The mean operation time was (285 ± 60)min for distal gastrectomy, (178 ± 62)min for proximal gastrectomy and (323 ± 86 )min for total gastrectomy. The average blood loss for distal gastrectomy, proximal gastrectomy, total gastrectomy was ( 140 ± 52) ml, ( 196 ± 85 ) ml and ( 234 ± 76) ml, respectively. The average number of lymph nodes dissected was (25 ± 10 ). The average time for gastrointestinal function recovery was 75 hrs. Duodenal stump fistula in 2 cases was cured by conservative therapy. Conclusions Laparoscopy-assisted D2 radical gastrectomy for early and advanced gastric cancer is feasible, safe, and minimally invasive.
出处
《中华普通外科杂志》
CSCD
北大核心
2008年第1期5-7,共3页
Chinese Journal of General Surgery
基金
国家自然科学基金资助项目(60601018)
北京市科技新星计划资助项目(2006A51)
军队“十五”计划医学科研重点课题(04Z019)
关键词
胃肿瘤
腹腔镜检查
胃切除术
Stomach neoplasms
Laparoscopy
Gastrectomy