腹腔镜根治性全胃切除术治疗进展期胃癌(附32例报告)

摘要

目的:探讨腹腔镜根治性全胃切除术治疗进展期胃癌的可行性及手术技巧.方法:回顾分析2011年10月至2013年1月为32例进展期胃癌患者行腹腔镜根治性全胃切除术的临床资料.结果:31例成功完成腹腔镜手术,1例中转开腹,中转率3.1％.手术时间平均(287.1±33.8) min,术中出血量平均(183.9±41.6) ml,平均每例清扫淋巴结(24.7±6.1)枚.术后4例发生并发症,无死亡病例.随访1～14个月,平均(8.6±2.9)个月,1例复发.结论:腹腔镜根治性全胃切除术治疗进展期胃癌是安全、可行的,可达到开腹手术的淋巴结清扫范围,但术者需具备一定的手术技巧.%Objective: To explore the feasibility and skills of laparoscopy assisted total gastrectomy (LATG) for advanced gastric cancer. Methods: The clinical data of 32 cases with advanced gastric cancer undergoing LATG from Oct. 2011 to Jan. 2013 were analyzed retrospectively. Results: Except for 1 patient with conversion to open surgery, 31 patients underwent LATG successfully, the conversion rate was 3. 1% . The mean operation time was (287. 1 ±33. 8) min,mean blood loss was (183. 9 ±41. 6) ml,and mean lymph nodes retrieved was (24. 7 ±6. 1). Four patients experienced complications postoperatively,and there was no postoperative death. After a mean follow-up of (8.6 ±2.9) months (range,1-14 months) ,only one case recurred. Conclusions:LATG is feasible,safe and effective in clearance of advanced gastric cancer. However, surgical skills should be mastered.