腹腔镜辅助胃癌根治术治疗进展期胃癌42例临床分析

摘要

Objective To explore the efficacies of laparoscopy- assisted gastrectomy (LAG)for gastric cancer.Methods The data of 42 patients undergoing LAG between January 2010 and July 2013 were collected retrospectively.Results All of them underwent LAG.Total (n =12),proximal (n =6) and distal (n =24)gastrectomies were performed.And the lymph node dissections included D1 +α(D1 +no.7)(n =6),D1 +β(D1 +no.7,8a & 9)(n =4)and D2 (n =32).For total,proximal and distal gastrectomies,the average operative duration was (3 10.0±35.5),(260.5 ±28.5)and (200.4 ±40.2)min and the average blood loss volume (270±60),(260.5±28.5)and (100±70)ml respec-tively.The postoperative outcomes were intra-abdominal hemorrhage (n = 1 ),gastrasthenia (n =2),anastomotic leakage (n =1)and lung infection (n =1).Conclusions LAG is both safe and feasible for advanced gastric cancer with mini-invasion and quick postoperative recovery.%目的：探讨腹腔镜辅助胃癌根治术临床疗效。方法回顾性分析2010年1月至2013年7月间收治42例腹腔镜胃癌根治术患者的临床资料。结果42例均成功完成腹腔镜辅助胃癌根治术,其中全胃切除12例,近端胃切除6例,远端胃切除24例。32例行胃癌 D2根治术,6例行 D1+α(D1+第7组淋巴结)根治术,4例行 D1+β(D1+第7、8a、9组淋巴结)根治术。平均手术时间全胃切除为(310.0±35.5)min,近端胃切除为(260.5±28.5)min,远端胃切除为(200.4±40.2)min。平均术中出血量全胃切除为(270±60)ml,近端胃切除为(220±40)ml,远端胃切为(100±70)ml。术后并发症包括腹腔内出血1例,胃瘫2例,吻合口瘘1例,肺内感染1例。结论腹腔镜辅助下胃癌根治术是治疗进展期胃癌安全、可行且近期疗效良好的手术方法。