Liew Victor, Taylor Craig, Ghusn Michael, Jamnagerwalla Murtaza, Layani Laurent
Division of Advanced Laparoscopic and Upper GI Surgery, John Flynn-Gold Coast Private Hospital, 42 Island Drive, Tugun, Queensland 4224, Australia.
ANZ J Surg. 2007 Sep;77(9):787-91. doi: 10.1111/j.1445-2197.2007.04224.x.
Despite significant advances in laparoscopy, gastric surgery is still generally carried out by conventional open techniques. The aim of the study was to report the short- and medium-term outcomes of gastric surgery when carried out laparoscopically for a variety of benign and malignant conditions.
A retrospective review was carried out for all patients who underwent a laparoscopic gastric resection between January 2000 and September 2006. Follow up was carried out at the private consulting rooms and by telephone interview.
Thirty-five consecutive laparoscopic gastric resection were carried out in 31 patients for a variety of benign lesions, six early gastric cancer and 13 adenocarcinomas. The totally intracorporeal laparoscopic procedures included four total, eight distal and 21 partial gastrectomies. There were two open conversions (6%). There was one in-hospital mortality (3%) and one non-fatal anastomotic leak. Median operative duration and length of stay were 75, 205 and 252 min and 5, 6.5 and 8 days for laparoscopic partial, distal and total gastrectomy, respectively. After malignant resections, there were six recurrences; however, 15 patients remained disease-free at up to 60 months follow up.
Laparoscopic gastric resection is feasible with good short- and medium-term results and may be an appropriate treatment option in selected cases.
尽管腹腔镜技术取得了重大进展，但胃部手术仍普遍采用传统的开放技术进行。本研究的目的是报告腹腔镜下针对各种良性和恶性疾病进行胃部手术的短期和中期结果。
对2000年1月至2006年9月期间接受腹腔镜胃切除术的所有患者进行回顾性研究。通过私人咨询室和电话访谈进行随访。
31例患者连续进行了35例腹腔镜胃切除术，治疗各种良性病变、6例早期胃癌和13例腺癌。完全腹腔镜内手术包括4例全胃切除术、8例远端胃切除术和21例部分胃切除术。有2例中转开腹手术（6%）。有1例住院死亡（3%）和1例非致命性吻合口漏。腹腔镜部分胃切除术、远端胃切除术和全胃切除术的中位手术时间分别为75、分钟、205分钟和252分钟，住院时间分别为天、5天、6.5天和8天。恶性肿瘤切除术后，有6例复发；然而，15例患者在长达60个月的随访中仍无疾病复发。
腹腔镜胃切除术是可行的，具有良好的短期和中期结果，在某些选定病例中可能是一种合适的治疗选择。
