中国实用外科杂志

中国实用外科杂志

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腹腔镜辅助保留幽门胃切除术治疗早期胃癌24例报告

徐    佳，赵恩昊，郁丰荣，汪    明，张子臻，邱江锋，曹    晖，赵    刚   

  1. 上海交通大学医学院附属仁济医院胃肠外科，上海200127
  • 出版日期:2016-09-01 发布日期:2016-08-24

  • Online:2016-09-01 Published:2016-08-24

摘要：

目的    探讨腹腔镜辅助保留幽门胃切除术（LAPPG）在早期胃癌治疗中的安全性和可行性。方法    回顾性分析上海交通大学医学院附属仁济医院胃肠外科2015年5月至2016年5月行LAPPG的24例早期胃体癌病人临床资料。结果    24例病人均成功实施LAPPG，无中转开放手术。手术时间（195.1±30.5）min，消化道重建时间（42.3±12.8）min，出血量（41.8±20.0）mL。术后排气时间（2.2±0.5）d，无严重手术相关并发症发生，术后中位住院时间为7 d。术后无病人出现严重营养不良，无病人出现严重餐后不适或胆汁反流性胃炎症状，中位随访时间4（1~12）个月，无病人发生肿瘤复发或死亡。结论    对于肿瘤位于胃中1/3的早期胃体癌病人，LAPPG安全可行，有利于改善病人术后生活质量。

关键词: 早期胃癌, 腹腔镜辅助保留幽门胃切除术, 腹腔镜

Abstract:

Laparoscopic assisted pylorus preserving gastrectomy in early gastric cancer：A report of 24 patients        XU Jia，ZHAO En-hao，YU Feng-rong，et al. Department of Gastrointestinal Surgery，Ren Ji Hospital，School of Medicine，Shanghai Jiao Tong University, Shanghai 200127,China
Corresponding author：ZHAO Gang，E-mail：zhaogang74313@aliyun.com
Abstract    Objective    To investigate the safety and feasibility of laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG) in early gastric cancer (EGC). Methods    The intraoperative and postoperative data of the 24 EGC patients with tumor in the middle third of the stomach receiving LAPPG in Renji Hospital, Shanghai Jiao Tong University School of Medicine from May 2015 to May 2016 were analyzed retrospectively. Results    ALL patients were received LAPPG successfully，without laparotomy conversion. The mean operation time of the LAPPG procedure was （195.1±30.5）min; time of digestive tract reconstruction was （42.3±12.8）min; estimated blood loss was （41.8±20.0）mL. No patients experienced severe postoperative complications. First flatus time was （2.2±0.5） days. The median length of postoperative hospital stay was 7 days. During the follow-up period，no patients suffered severe malnutrition，postprandial discomfort or bile reflux gastritis. The median length of the follow-up was 4(1-12)months, all the patients survived and no recurrence occurred at the end of the follow-up. Conclusion LAPPG is a safe and feasible treatment for middle-third EGC，which also can improve postoperative quality of life.

Key words: early gastric cancer, laparoscopic assisted pylorus preserving gastrectomy, laparoscopy