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目的探讨腹腔镜远端胃癌根治术的可行性及手术方法。方法行腹腔镜远端胃癌根治术15例,D1清扫3例,D2/D2+12例。全部病例均行毕Ⅱ式胃空肠吻合。结果15例成功进行腹腔镜手术。手术时间平均(218.6±31.6)min,术中出血量平均(132.4±21.3)ml,清扫淋巴结平均(33.4±13.6)个。肿瘤近端切缘(6.6±0.9)cm,远端切缘(5.4±0.6)cm,术后肛门排气时间平均(3.5±0.6)d,无手术死亡,无吻合口漏,术后并发肺部感染1例,经治疗后痊愈。术后随访1~10个月,无肿瘤复发或转移。结论腹腔镜远端胃癌根治术能达到与开腹胃癌标准根治术(D2)的淋巴结清扫范围及肿瘤切缘,且具有创伤小、出血少、术后恢复快等优点。
Objective To investigate the feasibility and operation of laparoscopic radical gastrectomy. Methods Laparoscopic radical gastrectomy in 15 cases, D1 clearance in 3 cases, D2 / D2 + 12 cases. All cases were completed Ⅱ type gastrojejunostomy. Results 15 cases were successfully performed laparoscopic surgery. The average operation time was (218.6 ± 31.6) min, the mean amount of bleeding during operation was (132.4 ± 21.3) ml, and the average lymph node dissection was (33.4 ± 13.6). There was no operative death, no anastomotic leakage and no postoperative pulmonary complications in the patients with tumor proximal to the margin (6.6 ± 0.9) cm and distal margin (5.4 ± 0.6) cm. The average time of postoperative anal exhaust was 3.5 ± 0.6 days Department of infection in 1 case, after treatment healed. Follow-up 1 to 10 months after surgery, no tumor recurrence or metastasis. Conclusions Radical laparoscopic radical gastrectomy can reach the range of lymph node dissection and tumor resection with standard radical operation of open gastric cancer (D2), and has the advantages of less trauma, less bleeding and quick recovery after operation.