[1]郑子芳 吴黎敏** 简陈兴 刘伟.扶镜手在腹腔镜胃癌D2根治术中淋巴结清扫的配合体会[J].中国微创外科杂志,2016,16(09):860-862.
　Zheng Zifang,Wu Limin,Jian Chenxing,et al.Coordination Experience for Lymph Node Dissection in Laparoscopic D2 Radical Gastrectomy for Gastric Cancer[J].Chinese Journal of Minimally Invasive Surgery,2016,16(09):860-862.
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扶镜手在腹腔镜胃癌D2根治术中淋巴结清扫的配合体会()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
16
期数:
2016年09期
页码:
860-862
栏目:
经验交流
出版日期:
2016-09-09

文章信息/Info

Title:
Coordination Experience for Lymph Node Dissection in Laparoscopic D2 Radical Gastrectomy for Gastric Cancer
作者:
郑子芳 吴黎敏** 简陈兴 刘伟
（莆田学院附属医院微创外科，莆田351100）
Author(s):
Zheng Zifang;  Wu Limin;  Jian Chenxing;  et al.
Minimally Invasive Surgery, Affiliated Hospital of Putian University, Putian 351100, China
关键词:
扶镜手; 腹腔镜; 胃癌
Keywords:
Laparoscopic assistant; Laparoscope; Gastric cancer
文献标志码:
B
摘要:
目的总结扶镜手在腹腔镜胃癌D2根治术中淋巴结清扫的配合体会。方法2012年10月~2016年3月完成腹腔镜胃癌D2根治术162例，肿瘤最大径0.5~9 cm，(3.8±3.4)cm。分析3个区淋巴结清扫的扶镜手注意事项。结果162例均成功完成腹腔镜辅助胃癌D2根治术，其中全胃切除101例，远端胃切除61例，手术时间分别为（190.2±39.5）min、（154.7±27.5）min，术中出血量（90.7±78.2）ml、（59.6±30.9）ml，淋巴结清扫数（28.0±8.8）枚、（23.0±6.9）枚。组织学分型：未分化或低分化型62例，中分化型54例，高分化型46例；术后TNM分期Ⅰ期30例，Ⅱ期40例，Ⅲ期55例，Ⅳ期37例。结论扶镜手要给术者一个清晰及稳定的画面，才能安全、快速完成手术。
Abstract:
ObjectiveTo summarize the coordination experience for lymph node dissection in laparoscopic D2 radical gastrectomy for gastric cancer. Methods A retrospective analysis was made on clinical data of 162 cases of laparoscopic D2 radical gastrectomy for gastric cancer in our department from October 2012 to March 2016. The maximum tumor diameter was 0.5-9 cm (38±3.4 cm). Attentions for laparoscopic assistant during lymph node dissection were summarized.ResultsThe laparoscopic assisted D2 radical gastrectomy were successfully completed in all the 162 cases, including total gastrectomy in 101 cases and distal gastrectomy in 61 cases. The total operative time was (190.2±39.5) min and (154.7±27.5) min, respectively, the intraoperative bleeding was (90.7±78.2) ml and (59.6±30.9) ml, respectively, and the number of lymph node harvested was (28.0±8.8) and (23.0±69), respectively, in total gastrectomy and distal gastrectomy. The histological type was undifferentiated and low differentiated type in 62 cases, moderately differentiated type in 54 cases, and well differentiated type in 46 cases. Postoperative TNM staging showed stage Ⅰ in 30 cases, Ⅱ in 40 cases, Ⅲ in 55 cases, and Ⅳ in 37 cases.ConclusionLaparoscopic assistant should help surgeon a clear and stable vision for the safe and quick completion of the operation.

参考文献/References:

[1]余佩武.腹腔镜胃癌手术的进展与展望.中国普外基础与临床杂志,2011,2（18）:105-109.
[2]周均，曹永宽，宋亚宁，等.手助腹腔镜胃癌D2根治手术的团队配合.中国微创外科杂志，2014,14（10）:892-895.
[3]Japanese Gastric Cancer Association.Japanese gastric cancer treatment guidelines 2010 (ver.3) Gastric Cancer,2011,14(2):113-123.
[4]郭吕.如何做好腹腔镜医师的持镜助手.中国微创外科杂志,2007,7(6):590.
[5]徐家朴,张家斌,张志勇,等.持镜医师在腹腔镜直肠癌根治术中的操作技巧. 中国微创外科杂志，2013,13（8）:762-763.
[6]Mori T,Kimura T,Kitaiima M．Skill accreditation system for laparoscopic gastroenterologic surgeons in Japan．Minim Invasive Ther Allied Technol,2010,19(1):18-23.

备注/Memo

备注/Memo:
基金项目：国家卫生计生委医药卫生科技发展研究中心项目（编号：W2013R60）**通讯作者，Email：ptxywlm@126.com
更新日期/Last Update: 2016-12-09