腹腔镜辅助早期胃癌根治术的临床研究（附18例报告）

目的探讨腹腔镜辅助胃癌根治术在早期胃癌中的临床应用。方法回顾性分析2006年5月至2009年12月间接受腹腔镜辅助胃癌根治术的早期胃癌病例的临床资料,包括手术方式、手术时间、术中失血量、排气时间、术后住院时间、术后病理、随访等。结果 18例手术均在腹腔镜辅助下完成,没有中转开腹。其中远端胃切除15例,近端胃切除3例,腹腔镜下D1＋α式淋巴结清扫13例,Dl＋β式淋巴结清扫2例,D2式淋巴结清扫3例。手术时间为（140.5±30.6）分钟,术中失血（120.7±20.2）mL,术后排气时间（3.0±0.5）天,术后住院天数为（9.7±1.2）天;3例（3/18）患者出现并发症,其中腹腔内出血、淋巴漏、切口感染各1例,经手术和非手术治疗后痊愈。标本上、下切缘病理检查均无肿瘤残留,平均清扫淋巴结（13.6±4.0）枚,其中有2例（2/18）发现淋巴结转移。除1例失访外,其余17例随访8-51月,均无肿瘤复发和远处转移。结论腹腔镜辅助胃癌根治术是治疗早期胃癌安全、可行、有效的手术方法。

Clinical research of laparoscopic-assisted radical gastrectomy for early gastric cancer (A report of 18 cases)

Objective To explore clinical application of laparoscopic-assisted radical gastrectomy for early gastric cancer.Methods Clinical data of 18 early gastric cancer cases accepting laparoscopic radical gastrectomy were retrospectively analyzed.Results All patients underwent laparoscopic surgery,without open procedure,including15 cases for distal gastrectomy,3 for proximal gastrectomy,13 for D1＋α lymph node dissection,2 for Dl＋β lymph node dissection and 3 for D2 lymph node dissection.Operation time was（140.5±30.6）minutes,blood loss was（120.7±20.2）mL,restoration of intestinal function time was（3.0±0.5）days,postoperative hospital stay was（9.7±1.2）days.There were 3 cases（3/18）with complications,intra-abdominal hemorrhage,lymphatic leakage and wound infection in 1 case,respectively.The mean lymph node dissection was 13.6±4.0,and 2 cases（2/18） were found lymph node metastasis.Seventeen cases were followed up for 8 to 51 months and 1 patient was lost outside,No tumor recurrence and distant metastasis were found.Conclusions Laparoscopic-assisted radical gastrectomy for the treatment of early gastric cancer is a safe,feasible and effective surgical method.