CAJ | 학술논문

目的探讨腹腔镜辅助进展期胃癌根治术的安全性及可行性.方法 2006年6月至2009年7月行腹腔镜辅助下胃癌D2根治术11例,TNM分期Ⅱ期6例、ⅢA期2例、ⅢB期1例、Ⅳ期2例,腹腔镜下行胃的游离及淋巴结清扫,于剑突下约6 cm长切口施行胃切除,并行消化道重建.结果 11例中,根治性全胃切除术2例,近端胃切除术1例,远端胃切除术7例,1例中转开腹.平均手术用时:全胃切除术350 min,近端胃切除术320 min,远端胃切除术266 min.平均清扫淋巴结21.3(11～38)枚,切缘长度5.6(4.0～9.6)cm.术后患者平均胃肠功能恢复时间72(36～110)h,下床活动时间59(26～86)h,进流食时间76(48～116)h.无一例出现手术相关并发症.结论经腹腔镜行进展期胃癌D2根治术安全、可行,与开腹手术的根治效果相当,近期效果良好,具有创伤小、术后恢复快等优点.
목적 탐토복강경보조진전기위암근치술적안전성급가행성.방법 2006년6월지2009년7월행복강경보조하위암D2근치술11례,TNM분기Ⅱ기6례、ⅢA기2례、ⅢB기1례、Ⅳ기2례,복강경하행위적유리급림파결청소,우검돌하약6 cm장절구시행위절제,병행소화도중건.결과 11례중,근치성전위절제술2례,근단위절제술1례,원단위절제술7례,1례중전개복.평균수술용시:전위절제술350 min,근단위절제술320 min,원단위절제술266 min.평균청소림파결21.3(11～38)매,절연장도5.6(4.0～9.6)cm.술후환자평균위장공능회복시간72(36～110)h,하상활동시간59(26～86)h,진류식시간76(48～116)h.무일례출현수술상관병발증.결론 경복강경행진전기위암D2근치술안전、가행,여개복수술적근치효과상당,근기효과량호,구유창상소、술후회복쾌등우점.
Objective To study the feasibility and safety of laparoscopy-assisted D2 radical gastrectomy for advanced gastric cancer. Methods From June, 2006 to July 2009, 11 patients with gastric cancer received laparoscopy-assisted gastrectomy for gastric cancer. According to UICC TNM classification of gastric cancer, 6 cases were with Stage Ⅱ, 2 cases with Stage Ⅲ A, 1 case with Stage Ⅲ B, and 2 cases with Stage Ⅳ. Under the assistance of laparoscope, dissociation of the stomach and lymph nodes clearance were performed first; then gastrectomy was performed on a 6 cm incision, samples were collected, and alimentary tract was inoculated. Results Among the 11 cases, 2 cases were performed radical total gastrectomy, 1 case was performed proximal partial gastrectomy, 7 cases were performed distal partial gastrectomy and 1 case with open surgery. The mean operation time: 350 min for total gastrectomy, 320 min for proximal partial gastrectom,266 min for distal partial gastrectomy. The mean number of harvested lymph nodes was 21.3 (11-38), incisal edge was 5.6 (4.0-9.6) cm. The mean time was 72 (36-110) hrs for gastrointestinal function recovery, 59 (26-86) hrs for patients to take general activity, and 76 (48-116) hrs to take liquid food. No complication was observed. Conclusion Laparoscopy-assisted D2 radical gastrectomy for advanced gastric cancer is safe and feasible. Compared with open surgery, it also has the advantages of small wound and fast recovery.