引用文本：王利明, 宋帛伦, 彭畔新, 等. 腹腔镜胃次全切除术的安全性及可行性分析[J/CD]. 消化肿瘤杂志（电子版）, 2026, 18(1): 83-88.

作者：王利明，宋帛伦，彭畔新，罗寿，陈瑛罡

单位：国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院胃肠外科，广东 深圳　518116

Authors：Wang Liming, Song Bolun, Peng Panxin, Luo Shou, Chen Yinggang

Unit：Department of Gastrointestinal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, Guangdong, China

摘要：

目的 介绍胃次全切除技术要点以及评价腹腔镜胃次全切除术（laparoscopic subtotal gastrectomy, LsTG）的安全性和可行性。方法 选取2022年1月至2025年5月中国医学科学院北京协和医学院肿瘤医院深圳医院胃肠外科15例接受LsTG的胃上部癌患者。主要手术步骤如下：①离断远端胃及确认近切缘阴性；②制作上提空肠袢；③残胃后壁与上提空肠进行侧侧吻合。收集患者的基线资料、围手术期结局及术后随访结果。结果 实施LsTG的患者中，男性9例，女性6例，平均年龄为（55.4±9.4）岁，体重指数为（20.8±2.9） kg/m²。近切缘（4.0±1.2） cm，远切缘（7.6±2.8）cm。术后病理分期：Ⅰ期9例, Ⅱ～Ⅲ期6例。中位手术时间为230（165~251） min，中位术中出血量为30（20～50） ml，术后恢复经口进食中位时间为6（4~7） d，术后住院中位时间为8（7~11） d。术后有5例患者出现早期并发症，包括肺部感染3例，乳糜漏2例。全组未发生B级及以上反流性食管炎，无患者需长期服用抑酸药物。术后中位随访时间为18个月，未见残胃吻合口复发及区域淋巴结复发。结论 LsTG应用于胃上部癌根治安全可行。

关键词：胃次全切除术；腹腔镜；淋巴结清扫

Abstract：

Objective To outline the key technical aspects of subtotal gastrectomy and evaluate the safety and feasibility of laparoscopic subtotal gastrectomy (LsTG). Method From January 2022 to May 2025, 15 patients with upper gastric cancer who underwent LsTG in the Department of Gastrointestinal Surgery at Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College were selected. The surgical procedure included: ①transection of the distal stomach and confirmation of negative proximal margins; ②preparation of the elevated jejunal loop; ③side-to-side anastomosis between the posterior gastric wall and the elevated jejunum. The baseline characteristics, perioperative outcomes, and postoperative follow-up data of these 15 patients were collected. Result Among the patients who underwent LsTG, 9 were male and 6 were female, with a mean age of (55.4±9.4) years. The mean body mass index was (20.8±2.9) kg/m². The proximal and distal margins were (4.0±1.2) cm and (7.6±2.8) cm, respectively. Postoperative pathological staging revealed 9 cases in stage Ⅰ and 6 cases in stages Ⅱ-Ⅲ. The median operation time was 230 (165-251) minutes, with a median intraoperative blood loss of 30 (20-50) ml. The median time to resume oral intake was 6 (4-7) days, and the median postoperative hospital stay was 8 (7-11) days. Early complications occurred in 5 cases, including pneumonia (3 cases) and chylous leakage (2 cases). No Grade B or higher reflux esophagitis were observed, and no patients required long-term acid suppression medication. With a median follow-up time of 18 months, no recurrence was detected at the gastric stump anastomosis site or regional lymph nodes. Conclusion LsTG is a safe and feasible procedure for radical resection of upper gastric cancer.

Key words：Subtotal gastrectomy; Laparoscopic; Lymphadenectomy

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