腹腔镜远端胃癌D2根治手术的路径

摘要

目的：探讨腹腔镜端胃癌D2根治术的合理手术路径.方法：分析23例行腹腔镜端胃癌D2根治手术治疗的手术路径.结果：23例中22例完成腹腔镜手术,手术时间平均(232±35)min,术中出血平均(130±50)mL,平均清扫淋巴结(19±5)枚,术后胃肠功能恢复时间2~4 d.结论：腹腔镜端胃癌D2根治手术遵循从下到上、从右到左、从胃大弯到胃小弯的操作顺序是合理、可行的,淋巴清扫时,胰腺是手术操作的主要解剖定位标志,胃十二指肠动脉是最重要的血管定位标志.%Objective To study the operation path in laparoscopic gastrectomy with D2 lymphadenectomy for distal gastric cancer. Methods The operation path was analysed in 23 patients undergoing laparoscopic gastrectomy with D2 lymphadenectomy for distal gastric cancer. Results Twenty two patients underwent lapa⁃roscopic radical gastrectomy.The average operation time was(232±35)min,mean blood loss was(130±50) mL,average harvested lymph nodes was 19±5,and mean time for gastrointestinal function recovery was 2~4 days. Conclusion The sequence of procedure of from bottom to top, from right to left, from the greater curva⁃ture to the lesser curvature in laparoscopic gastrectomy with D2 lymphadenectomy for distal gastric cancer is rea⁃sonable and feasible. The pancreas is the main operating anatomic landmark; the gastroduodenal artery is the main vascular landmark.