腹腔镜_____胃肿瘤；胃切除术；腹腔镜

腹腔镜近端胃大部切除7例体会

http://www.100md.com 《腹腔镜外科杂志》 2006年第2期

腹腔镜,,胃肿瘤；胃切除术；腹腔镜,1资料与方法,2结果,3讨论,参考文献：

     【摘要】目的：探讨腹腔镜近端胃大部切除的方法、效果及可行性。方法：回顾分析腹腔镜胃大部切除7例的临床资料。结果：7例均在腹腔镜下成功完成手术，平均用时278min(237～356min)，术中平均出血量120ml(60～300ml),病理检查低分化腺癌4例，中分化腺癌2例，高分化腺癌1例，均未见残端肿瘤残余，切缘距肿瘤边缘59cm(35～85cm)，平均清扫淋巴结142个(7～21个)。术后患者第1次排气时间342h(18～69h)，第1次离床活动时间427h(38～77h)，术后24h即鼓励患者少量喝水，未出现腹胀或呕吐。术后平均住院84d(7～11d)，未进行化疗，随访2～13月，无复发。结论：腹腔镜近端胃大部切除术安全、可行，能够达到与开腹手术相当的根治效果，具有患者创伤小，术后康复快等优点。

    【关键词】胃肿瘤；胃切除术；腹腔镜

    Laparoscopic proximal gastrectomy:a report of 7 cases

    BAI Jianfeng,SUN Yueming,LU Wenxiong,et al.

    Dept.of MiniInvasive Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China

    【Abstract】 Objective:To explore the method,effect and feasibility of laparoscopic proximal gastrectomy.Methods:The clinical data of seven cases were analyzed retrospectivecy.Results:All cases were operated with laparoscopic method successfully.The mean operative time was 278min (237356min).The mean blood loss was 120ml(60300ml).Pathology results included 4 cases of low differential adenoma,2 cases of middle differential adenoma and 1 case of high differential adenoma.The mean distance from incision edge to the tumour was 5.9cm(3.58.5cm).The mean number of lymph nodes dissected was 14.2(721).Time of bowel pass was 34.2h(1869h).Time of bedside movement was 42.7h(3877h).Patients were encouraged to drink water 24h after operation,no vomitting was observed.The mean hospitalization was 8.4d(711d).No recurrence was observed during the 213 months followup.Conclusions:Laparoscopic proximal gastrectomy is a safe procedure and matches the results of open operation.It has the merits of less trauma and rapid recovery. ......

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