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目的探讨腹腔镜下胃癌D2根治术的可行性及其优缺点。方法对2006年5月～2007年4月期间完成的15例腹腔镜下胃癌D2根治手术临床资料进行回顾和总结。结果手术平均用时:全胃切除235min,近端胃切除214min,远端胃切除192.5min;术中平均出血量:全胃切除370ml,近端胃切除320ml,远端胃切除290ml;术后患者平均胃肠功能恢复时间89.6h;下床活动时间平均84.6h;术后人均镇痛次数为0.21次;所有标本病理检查切缘皆阴性,平均清扫淋巴结17.2枚;平均费用28490元;无吻合口漏等并发症。结论使用腹腔镜可以完成胃癌D2根治手术,患者痛苦小、恢复快,清扫淋巴结仍然需要加强,费用有待于进一步下降。
Objective To investigate the feasibility and advantages and disadvantages of laparoscopic D2 radical mastectomy for gastric cancer. Methods The clinical data of D2 radical operation of laparoscopic gastric cancer from May 2006 to April 2007 were reviewed and summarized. Results The mean time of operation was total gastrectomy 235min, proximal gastrectomy 214min and distal gastrectomy 192.5min. The mean intraoperative blood loss was 370ml total gastrectomy, 320ml proximal gastrectomy and 290ml distal gastrectomy. The average postoperative patients’ The recovery time of gastrointestinal function was 89.6h; the average time to get out of bed was 84.6h; the average number of postoperative analgesia was 0.21 times; the margins of all specimens were negative, the average lymphadenectasis was 17.2; the average cost was 28,490 yuan; Other complications. Conclusions Laparoscopic surgery can be used to cure radical resection of gastric cancer with D2. The patient has little pain and quick recovery. The lymph node dissection still needs to be strengthened and the cost needs to be further reduced.