中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2013年
1期
22-25
,共4页
陈钶%牟一平%徐晓武%王捷%严加费%张人超%周育成
陳鈳%牟一平%徐曉武%王捷%嚴加費%張人超%週育成
진아%모일평%서효무%왕첩%엄가비%장인초%주육성
胃肿瘤%腹腔镜检查%胃切除术
胃腫瘤%腹腔鏡檢查%胃切除術
위종류%복강경검사%위절제술
Stomach neoplasms%Laparoscopy%Gastrectomy
目的 探讨完全腹腔镜根治性全胃切除术(TLTG)的可行性、安全性及治疗效果.方法 回顾性分析2007年11月至2011年10月施行TLTG与开腹根治性全胃切除术(OTG)患者的临床资料.对2组的手术安全性、术后恢复及肿瘤根治性进行比较.结果 共90例患者纳入本研究,其中TLTG组18例,OTG组72例.TLTG组手术时间[(310±86) min]明显延长(t=4.963,P =0.002),但术中出血量[(136±84) ml]较OTG组[(359±141)ml]少(t=-11.734,P=0.000).两组间并发症发生率差异无统计学意义(P＞0.05).在术后肛门排气时间(t=-7.020)、术后进食时间(t=-6.166、-5.698)、术后住院时间(t=-4.610)方面,TLTG组均较OTG组有优势(P＜0.05).结论 完全腹腔镜根治性全胃切除术安全可行,具有切口小、术后恢复快等优点；腹腔镜食管-空肠侧侧吻合法是腹腔镜全胃切除后一种简单、安全的消化道重建吻合方式.
目的 探討完全腹腔鏡根治性全胃切除術(TLTG)的可行性、安全性及治療效果.方法 迴顧性分析2007年11月至2011年10月施行TLTG與開腹根治性全胃切除術(OTG)患者的臨床資料.對2組的手術安全性、術後恢複及腫瘤根治性進行比較.結果 共90例患者納入本研究,其中TLTG組18例,OTG組72例.TLTG組手術時間[(310±86) min]明顯延長(t=4.963,P =0.002),但術中齣血量[(136±84) ml]較OTG組[(359±141)ml]少(t=-11.734,P=0.000).兩組間併髮癥髮生率差異無統計學意義(P＞0.05).在術後肛門排氣時間(t=-7.020)、術後進食時間(t=-6.166、-5.698)、術後住院時間(t=-4.610)方麵,TLTG組均較OTG組有優勢(P＜0.05).結論 完全腹腔鏡根治性全胃切除術安全可行,具有切口小、術後恢複快等優點；腹腔鏡食管-空腸側側吻閤法是腹腔鏡全胃切除後一種簡單、安全的消化道重建吻閤方式.
목적 탐토완전복강경근치성전위절제술(TLTG)적가행성、안전성급치료효과.방법 회고성분석2007년11월지2011년10월시행TLTG여개복근치성전위절제술(OTG)환자적림상자료.대2조적수술안전성、술후회복급종류근치성진행비교.결과 공90례환자납입본연구,기중TLTG조18례,OTG조72례.TLTG조수술시간[(310±86) min]명현연장(t=4.963,P =0.002),단술중출혈량[(136±84) ml]교OTG조[(359±141)ml]소(t=-11.734,P=0.000).량조간병발증발생솔차이무통계학의의(P＞0.05).재술후항문배기시간(t=-7.020)、술후진식시간(t=-6.166、-5.698)、술후주원시간(t=-4.610)방면,TLTG조균교OTG조유우세(P＜0.05).결론 완전복강경근치성전위절제술안전가행,구유절구소、술후회복쾌등우점；복강경식관-공장측측문합법시복강경전위절제후일충간단、안전적소화도중건문합방식.
Objective To investigate the feasibility,safety and oncological effect of totally laparoscopic total gastrectomy (TLTG).Methods The clinical data of TLTG cases and open total gastrectomy (OTG) patients between Novembe 2007 and October 2011 were analyzed.Also compared the feasibility,safety and short-term outcomes of TLTG with OTG.Results Ninty cases were analyzed.There were 18 cases in the TLTG group and 72 cases in the OTG group.Operation time was significantly longer in the TLTG group ((310 ±86) minutes) than in the OTG group ((256 ±57)min,t =4.963,P =0.002),However,the blood loss were significantly lower in the TLTG group ((136 ± 84) ml vs.(359 ± 141) ml,t =-11.734,P =0.000).The post operative morbidity was similar between the TLTG and OTG group.First flatus time (t =-7.020),first diet time (t =-6.166 and-5.698),and post operative hospital stay (t =-4.610) were significantly shorter in the TLTG group than in the OTG group (P ＜ 0.05).Conclusions LTG is a safe and feasible procedure with quick post-operation recovery.The laparoscopic side-to-side esophagojejunal anastomosis is a safe and feasible method of alimentary reconstruction after laparoscopic total gastrectomy.
