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目的:初步评价手助腹腔镜胃癌根治术的近期疗效。方法:回顾性分析2010年12月—2012年7月完成的手助腹腔镜胃癌根治术100例患者的临床资料和随访记录。结果:实施手助腹腔镜胃癌根治术102例,中转开腹2例(1.96%)。成功完成手术100例,全胃切除术53例,远端胃切除术39例,近端胃切除术8例;联合胆囊切除术4例,联合左肝外叶部分切除术2例,联合胰体尾部分切除+脾切除术1例。平均手术切口长度(6.81±0.29)cm;术中出血量(244.10±117.02)mL;手术时间(172.28±24.02)min;病理检获淋巴结数(17.10±5.70)枚;术后住院时间(10.20±3.84)d。无围手术期死亡,手术相关并发症率9%(9/100)。术后随访时间1~12个月,失访率6%(6/100),同时性肝转移3例,异时性淋巴结转移1例,局部复发1例。结论:手助腹腔镜胃癌D2根治术安全、可靠,近期疗效良好,且并不会增加肿瘤在腹腔转移的机会。
Objective: To evaluate the short-term curative effect of hand-assisted laparoscopic radical gastrectomy. Methods: The clinical data and follow-up records of 100 cases of hand-assisted laparoscopic radical gastrectomy performed from December 2010 to July 2012 were retrospectively analyzed. Results: 102 cases of hand-assisted laparoscopic radical gastrectomy performed in 2 cases (1.96%). Successful completion of the operation in 100 cases, total gastrectomy in 53 cases, distal gastrectomy in 39 cases, proximal gastrectomy in 8 cases; combined cholecystectomy in 4 cases, combined with left extrahepatic partial resection in 2 cases, combined pancreatic body Tail partial resection + splenectomy in 1 case. The average operative incision length was (6.81 ± 0.29) cm; the blood loss during operation was (244.10 ± 117.02) mL; the operation time was 172.28 ± 24.02 min; the number of pathologic node was 17.10 ± 5.70; the postoperative hospital stay was 10.20 ± 3.84 d. No perioperative deaths occurred, with 9% (9/100) complications related to surgery. The follow-up time ranged from 1 to 12 months, the rate of follow-up was 6% (6/100), simultaneous liver metastasis in 3 cases, abnormal lymph node metastasis in 1 case and local recurrence in 1 case. Conclusion: D2-assisted hand-assisted laparoscopic radical gastrectomy is safe, reliable and has good short-term efficacy. It does not increase the chance of tumor metastasis in the abdominal cavity.