腹腔镜辅助胃癌根治术治疗早期胃癌的临床研究普外科专业论文.docxVIP

上海交通大学医学院硕士学位论文 上海交通大学医学院硕士学位论文 IV IV 型21例(20.2％)，印戒细胞癌13例(12.5％)；共有9名病人发生淋巴结转 移(8.7%)。随访时间11～82个月，中位33个月，共两名患者死亡，未见 肿瘤复发，患者5年总体生存率为98.1％，肿瘤相关生存率99.0%。 结论 腹腔镜辅助胃癌根治术治疗早期胃癌不仅具有微创优势，且能达到 满意的远期疗效，值得临床推广。 【关键词】胃肿瘤；胃切除术；腹腔镜手术 PAGE PAGE VI Clinical analysis of Lapaproscopic assisted radical gastrectomy for early gastric cancer Abstract Objective To evaluate laparoscopy-assisted curative gastrectomy for early gastric cancer(EGC)． Methods We reviewed the medical records of 105 consecutive patients underwent laparoscopy-assisted curative gastrectomy for EGC at Shanghai Minimally Invasive Surgery Center between October 2004 and December 2010 and were followed up until August 2011. The clinical and pathological characteristics were evaluated. Results Among 105 procedures, 98 laparoscopy-assisted distal gastrectomy(LADG),2 laparoscopy-assisted proximal gastrectomy(LAPG),and 4 laparoscopy-assisted total gastrectomy(LATG) were performed.1 patient was converted to conventional open gastrectomy due to SMV bleeding intraoperatively. Whereas the numbers of Dl+α,Dl+β,and D2 lymph node dissections were 41,20,and 43,respectively. The operation time was(202.8±44.5)min，blood loss was(161.3±149.1)ml, and the postoperative hospital stay was(10.5±2.3)d．Early postoperative complications including anastomotic leakage，intra-abdominal bleeding, intestinal obstruction, intra-abdominal fluid collection and delayed gastric emptying occurred in 10 patients(9.5％).The lengths of proximal and distal resection margin were(3.7±1.8)cm and(3.5±1.7)cm，respectively. There are 65 (62.5%)mucosal carcinomas and 39 (37.5%)sub-mucosal carcinomas. The number of the lymph nodes dissected was 15.3±7.8 and lymph node metastases were found in 9 patients．There are 33 (31.7％)high differentiated cancers,37 (35.6％)moderate differentiated cancers,21 (20.2％)low differentiated cancers and 13(12.5％)signet ring cell cancers；The median follow-up period was 33 months(range, 11-82 months). 1 patient with T1bN2M0 gastric cancer