中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2012年
12期
1265-1268
,共4页
黄昌明%林建贤%郑朝辉%李平%谢建伟%王家镔%陆俊%陈起跃
黃昌明%林建賢%鄭朝輝%李平%謝建偉%王傢鑌%陸俊%陳起躍
황창명%림건현%정조휘%리평%사건위%왕가빈%륙준%진기약
胃肿瘤%胃切除术%腹腔镜%治疗效果
胃腫瘤%胃切除術%腹腔鏡%治療效果
위종류%위절제술%복강경%치료효과
Stomach neoplasms%Gastrectomy%Laparoscopy%Treatment outcomes
目的 探讨腹腔镜辅助胃根治术的安全性和临床疗效.方法 回顾性分析2007年5月至2012年8月间在福建医科大学附属协和医院行腹腔镜辅助胃癌根治术的1380例患者的临床资料.结果 全组中转开腹率1.2％(17/1380),手术时间(196.2±59.2) min,术中出血量(79.7±115.8) ml,淋巴清扫数目(30.1±11.0)枚/例.术后首次下床活动时间(2.4±1.0)d,肛门排气时间(3.3±1.2)d,进食流质时间(4.2±1.6)d,住院时间(12.4±8.5)d.术后并发症发生率为12.1％(167/1380),围手术期死亡率为0.4％(5/1380).按手术例数(手术经验)进行相关分析显示,手术中转开腹率和手术时间随手术例数增多而下降,而淋巴结清扫数目随手术例数的增加而增多(均P＜0.05).1332例(96.5％)患者获术后随访,中位随访时间19个月,术后3年生存率为71.0％.结论 腹腔镜辅助胃癌根治术安全可行,且具有较好的临床疗效.随着外科医师技术的不断成熟,手术中转开腹率、手术时间及淋巴结清扫数目均能逐步改善.
目的 探討腹腔鏡輔助胃根治術的安全性和臨床療效.方法 迴顧性分析2007年5月至2012年8月間在福建醫科大學附屬協和醫院行腹腔鏡輔助胃癌根治術的1380例患者的臨床資料.結果 全組中轉開腹率1.2％(17/1380),手術時間(196.2±59.2) min,術中齣血量(79.7±115.8) ml,淋巴清掃數目(30.1±11.0)枚/例.術後首次下床活動時間(2.4±1.0)d,肛門排氣時間(3.3±1.2)d,進食流質時間(4.2±1.6)d,住院時間(12.4±8.5)d.術後併髮癥髮生率為12.1％(167/1380),圍手術期死亡率為0.4％(5/1380).按手術例數(手術經驗)進行相關分析顯示,手術中轉開腹率和手術時間隨手術例數增多而下降,而淋巴結清掃數目隨手術例數的增加而增多(均P＜0.05).1332例(96.5％)患者穫術後隨訪,中位隨訪時間19箇月,術後3年生存率為71.0％.結論 腹腔鏡輔助胃癌根治術安全可行,且具有較好的臨床療效.隨著外科醫師技術的不斷成熟,手術中轉開腹率、手術時間及淋巴結清掃數目均能逐步改善.
목적 탐토복강경보조위근치술적안전성화림상료효.방법 회고성분석2007년5월지2012년8월간재복건의과대학부속협화의원행복강경보조위암근치술적1380례환자적림상자료.결과 전조중전개복솔1.2％(17/1380),수술시간(196.2±59.2) min,술중출혈량(79.7±115.8) ml,림파청소수목(30.1±11.0)매/례.술후수차하상활동시간(2.4±1.0)d,항문배기시간(3.3±1.2)d,진식류질시간(4.2±1.6)d,주원시간(12.4±8.5)d.술후병발증발생솔위12.1％(167/1380),위수술기사망솔위0.4％(5/1380).안수술례수(수술경험)진행상관분석현시,수술중전개복솔화수술시간수수술례수증다이하강,이림파결청소수목수수술례수적증가이증다(균P＜0.05).1332례(96.5％)환자획술후수방,중위수방시간19개월,술후3년생존솔위71.0％.결론 복강경보조위암근치술안전가행,차구유교호적림상료효.수착외과의사기술적불단성숙,수술중전개복솔、수술시간급림파결청소수목균능축보개선.
Objective To explore the technical feasibility,safety,and clinical efficacy of laparoscopy assisted radical gastrectomy(LAG) for patients with gastric cancer.Methods Clinical data of 1380 patients with gastric cancer who received LAG from May 2007 to April 2012 were analyzed retrospectively.Results LAG was successfully carried out in 1363 patients,and 17 patients (1.2％) were converted to open surgery.The mean operation time,blood loss,number of dissected lymph nodes were (196.2±59.2) minutes,(79.7±115.8) ml,and 30.1±11.0,respectively.The average time to ground activities,time to flatus,time to fluid diet,and length of hospital stay were (2.4±1.0) days,(3.3±1.2) days,(4.2±1.6) days,and (12.4±8.5) days,respectively.The postoperative morbidity was 12.1％ and the mortality was 0.4％.According to Simple Scatter analysis,the number of surgical cases (surgeons' experience) was negatively related with the rate of converted to open surgery and operation time,but positively with number of dissected lymph nodes.A total of 1332 patients were followed up for 2-51 months (median 19 months),and the 3-year survival rate was 71.0％,the 3-year survival rates in stage Ⅰ,stage Ⅱ,and stage Ⅲ were 94.5％,83.9％,and 56.7％,respectively.Conclusion Laparoscopy assisted radical gastrectomy is a safe and feasible procedure with better clinical efficacy for gastric cancer.With improvement in the surgical technology,the conversion rate and operation time decrease,and the number of dissected lymph nodes will increase.
