腹腔镜胃癌根治术的临床疗效.DOCVIP

临床医学论文-腹腔镜胃癌根治术的临床疗效 ???????????? 作者：余佩武 钱锋 罗华星 王自强 赵永亮 石彦 唐波 【摘要】? 目的 探讨腹腔镜胃癌根治术的临床疗效。方法 回顾性分析2004年3月至2007年8月我院321例腹腔镜胃癌根治术患者的临床资料。行根治性全胃切除术63例，近端胃大部切除术52例，远端胃大部切除术198例，联合脏器切除术8例。结果 321例患者有317例成功实施腹腔镜胃癌根治术，4例中转开腹。手术平均时间：全胃切除术(323±58)min，近端胃切除术(268±76)min，远端胃切除术(274±52)min，联合脏器切除术(335±32)min。术中平均出血量(120±82)ml，平均清扫淋巴结(35.2±13.5)枚，胃癌标本近、远切缘长度分别为(6.3±1.7)cm和(5.8±1.9)cm。术后有26例患者出现并发症，2例围手术期死亡。319例随访3～43个月，随访期内有50例复发，其中45例为单一类型复发，5例为多种类型复发。结论 腹腔镜胃癌根治术安全、可行，能够达到与开腹手术相当的根治效果，具有广阔的应用前景。 【关键词】? 胃肿瘤； 根治性切除； 腹腔镜 ???????? 【Abstract】? Objective? To investigate the feasibility, safety, complication and outcome of laparoscopicassisted radical gastrectomy for gastric cancer. Methods? The clinical data of 321 gastric cancer patients received laparoscopicassisted radical gastrectomy from March 2004 to August 2007 were analyzed retrospectively. Radical total gastrectomy were performed on 63 patients, proximal subtotal gastrectomy on 52, distal subtotal gastrectomy on 198 and combined organs resection on 8. Results? A total of 317 patients successfully underwent laparoscopicassisted surgery and the other 4 were conversed to open surgery. The mean operation time was (323±58) minutes for total gastrectomy, (268±76) minutes for proximal subtotal gastrectomy, (274±52) minutes for distal subtotal gastrectomy and (335±32) minutes for combined organs resection, respectively. The mean volume of blood loss, numbers of harvested lymph nodes, lengths of upper and lower segment of resection for gastric cancer was (120±82) ml, 35.2±13.5, (6.3±1.7) cm and (5.8±1.9) cm, respectively. Twentysix patients occurred postoperative complications, and 2 died during operation. Of all, 319 patients were followed up for 343 months, and 50 patients had recurrence, including 45 with single pattern recurrence and 5 with multiple patterns recurrence. Conclusions? Laparoscopicassisted radical gastrectomy is feasible and safe, and can achieve the same outcomes as the open operation. ??? 【Key words】? Gastric ne