摘要
目的探讨3D腹腔镜胃癌根治术的临床价值。方法采用回顾性描述性研究方法。收集2014年10月至2016年3月南京医科大学第一附属医院收治的28例行3D腹腔镜胃癌根治术患者的临床资料。Troear放置及手术过程与传统2D腹腔镜胃癌根治术相同。观察指标：（1）手术情况：手术时间、术中出血量、淋巴结清扫数目。（2）术后情况：术后下床活动时间、术后肛门排气时间、术后进流质食物时间、术后并发症发生情况、术后住院时间。（3）随访情况。采用门诊和电话方式进行随访，了解患者术后生存及肿瘤复发、转移情况。随访时间截至2016年5月1日。正态分布的计量资料以面±s表示。结果（1）手术情况：28例患者均成功完成3D腹腔镜胃癌根治术，无中转开腹，无患者围术期死亡。其中7例患者行3D腹腔镜辅助全胃切除食管空肠Roux-ell-Y吻合术，手术时间为（214±47）min；21例患者行3D腹腔镜远端胃癌根治性切除胃空肠uncutRoux-ell-Y吻合术，手术时间为（181±27）min。28例患者术中出血量为（53±29）mL，淋巴结清扫数目为（34±10）枚。（2）术后情况：28例患者术后下床活动时间为（54±17）h，术后肛门排气时间为（77±16）h，术后进流质食物时间为（5．0±1．1）d。28例患者中，1例术后发生}肖化道出血，经保守治疗后治愈，其余患者术后无并发症发生。术后住院时间为（8．8±1．6）d。（3）随访情况：28例患者术后均获得随访，随访时间为2～18个月，中位随访时间为10个月。随访期间，患者均生存，无肿瘤复发、转移，仅1例行3D腹腔镜远端胃癌根治性切除胃空肠uncutRoux-erl-Y吻合术的患者出现输入襻再通，患者无明显不适，定期复查胃镜，观察胆汁反流等情况。结论3D腹腔镜胃癌根治术安全可行，近期疗效较好。
Objective To investigate the clinical value of three-dimensional （3D） laparoscopic radical gastrectomy for gastric cancer. Methods The retrospective and descriptive study was adopted. The clinical data of 28 patients who underwent 3D laparoscopic radical gastrectomy for gastric cancer at the First Affiliated Hospital of Nanjing Medical University from October 2014 to March 2016 were collected. Trocar placement and surgical procedures were the same as 2D laparoscopic radical gastrectomy. Observation indicators included （ 1 ） surgical situations： operation time, volume of intraoperative blood loss, number of lymph node dissected, （2） postoperative situations： time for out-of-bed activity, time to anal exsufflation, time for fluid diet intake, occurrence of complications and duration of hospital stay, （ 3 ） follow-up situations. The follow-up was performed to detect postoperative survival of patients and tumor recurrence and metastasis by outpatient examination and telephone interview up to May 1st, 2016. Measurement data with normal distribution were presented as x± s. Results （1） Surgical situations： all the 28 patients underwent successful 3D laparoscopic radical gastrectomy, without conversion to open surgery and perioperative death. Seven patients received 3D laparoscopy assisted total gastrectomy with Roux-en-Y esophagojejunostomy, with operation time of （214 ± 47）minutes. Twenty-one patients underwent 3D laparoseopic distal gastrectomy with uncut Roux-en-Y gastrojejunostomy, with operation time of （181 ± 27）minutes. Volume of intraoperative blood loss and number of lymph node dissected in 28 patients were （53 ± 29 ）mL and 34 ± 10. （2） Postoperative situations： time for out-of-bed activity, time to anal exsufflation and time for fluid diet intake were （ 54 ± 17 ） hours, （ 77 ± 16） hours and （5.0 ± 1. 1 ） days, respectively. Of 28 patients, 1 complicated with gastrointestinal hemorrhage was cured by conservative treatment, and other patients had no
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2016年第9期888-891,共4页
Chinese Journal of Digestive Surgery
基金
国家自然科学基金（81572362）
关键词
胃肿瘤
胃切除术
腹腔镜检查
3D技术
Gastric neoplasms
Gastreetomy
Laparoscopy
Three-dimensional technique
