手辅助腹腔镜胃癌根治手术技巧探讨.pdf

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1、渔化壁瘗盘查(鱼王题21Q!!墅．旦箜垒鲞箜!塑量．pigOncol(ElectronieVersion),June2012Vol4No．293·论著·手辅助腹腔镜胃癌根治手术技巧探讨刘逸揭志刚李正荣曹毅【摘要】目的探讨于辅助腹腔镜胃癌根治手术的可行性、手术技巧及短期治疗效果。方法对2009年11月至2011年6月我科施行的14例手辅助腹腔镜胃癌根治手术患者的临床资料进行回顾性分析，分析患者手术时间、术中出血量、术后肛门排气H,-tf日q、住院时间、淋巴结清扫数目以及短期随访结果。结果全组14例患者手术均成功，无中转开腹。手术中位时间13

2、0rain(90-180min)；术中出血量50～150ml，平均(102．3±26．5)ml；术后排气时间2-4d，平均(3．2±1．3)d；术后开始进食时间(4．5±1．4)d；患者住院天数7。12d，平均住院天数(9．O±2．5)d：手术清扫淋巴结数目18-27枚，平均(22．2±5．3)枚。无围手术期并发症及死亡病例。随访2～20个月．1例ⅢC期患者死亡。结论手辅助腹腔镜胃癌根治手术具有与腹腔镜辅助胃癌根治手术同样的微创效果，但操作相对容易，更适合有丰富开腹手术经验，而腹腔镜技术薄弱的高年资医生。【关键词】胃癌；手辅助腹腔镜手术F

3、easibilityandoperativeskillsofhand-assistedlaparoscopicradicalsurgeryforgastriccancer：areportof14casesLIUYi，JIEZhi—gang，LIZheng—rong，CAOYi．DepartmentofGeneralSurgery，theFirstAffiZ妣aHospitalofNanchangUniversity，Nanchang330006，China．Correspondingauthor：JIEZhi—gang，E—mail：ji

4、ez9123@126．cornfAbstract】ObjectiveToinvestigatethefeasibilityandoperativeskillsofhand-assistedlaparoscopicradicalforcancer．MethodsFromNovember2009toJune201casesofsurgerygastric1，fourteengastriccancerunderwenthand—assistedlaparoscopicradicalresectioninourdepartment．Clinica

5、ldataincludingandshort-terrawereoperativetime，intra—operativebleeding，hospitalstayfollow—upanalyzed．ResultsHand·assistedlaparoscopicradicalresectionwassuccessfullyperformedinall14easeswithoutconversiontomedianoperationtimewas130minwithafrom90to180rain．openlaparotomy．Thera

6、ngeThemeanintra—operativebloodlossWas(102．3_+26．5)m1．Themeananalexhausttimewas(3．2±1．3)d，andmeantimetooralfeeding(4．5±1．4)d．Themeannumberofharvestedlymphnodeswas(22．2±5．3)．Themeanhospitalstaywas(9．0-+2．5)d．Therewerenoperi-operativemorbidityandmortality．OnlyORedeathoccurre

7、dafterafollow—upfrom2to20month．ConclusionsHand—assisted[aparoscopieradicalsurgeryforgastriccanerhasthesameminimallyinvasiveeffectaslaparoscopy·assistedradicalgastrectomy，andiscomparativelyeasier．Itismoresuitablefortheseniordoctorswithrichexperienceofandpoorofopensurgeryex

8、periencelaparoscopicoperations．【Keywords】Gastriccancer；Hand—assistedlaparoscopicsurgery近年来．随着微创技