A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan
A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan
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DOI：
10.1097/01.sla.0000225364.03133.f8
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发表时间：
2007-01-01
影响因子：
9
通讯作者：
Tanigawa, Nobuhiko
中科院分区：
文献类型：
--
作者：
Kitano, Seigo;Shiraishi, Norio;Tanigawa, Nobuhiko
背景资料：腹腔镜手术治疗胃癌在技术上是可行的，但由于没有从肿瘤学结果的角度进行评估，因此尚未被广泛接受。我们进行了一项回顾性，多中心研究，在日本的一个大系列的患者，以评估腹腔镜胃切除术早期胃癌（EGC）的短期和长期的结果：研究组包括1294例患者进行腹腔镜胃切除术期间，1994年4月至2003年12月在16个参与手术单位（日本腹腔镜手术研究组）。结果：远端胃切除术1185例（91.5%），近端胃切除术54例（4.2%），全胃切除术55例（4.3%）;所有患者均在腹腔镜下进行。与这些手术相关的发病率和死亡率分别为14.8%和0%。组织学上，1212例患者（93.7%）患有iA期疾病，75例（5.8%）患有113期疾病，7例（0.5%）患有II期疾病（UICC分期）。在1294例接受治愈性治疗的患者中，仅6例（0.6%）癌症复发（中位随访时间为36个月;范围为13-113个月）。IA期疾病的5年无病生存率为99.8%，113期疾病为98.7%，II期疾病为85.7%。结论：虽然我们的研究结果可能被认为是初步的，我们的数据表明，腹腔镜手术EGC产生良好的短期和长期的肿瘤结局。
Background: Laparoscopic surgery for gastric cancer is technically feasible, but it is not widely accepted because it has not been evaluated from the standpoint of oncologic outcome. We conducted a retrospective, multicenter study of a large series of patients in Japan to evaluate the short- and long-term outcomes of laparoscopic gastrectomy for early gastric cancer (EGC).Methods: The study group comprised 1294 patients who underwent laparoscopic gastrectomy during the period April 1994 through December 2003 in 16 participating surgical units (Japanese Laparoscopic Surgery Study Group). The short- and long-term outcomes of these patients were examined.Results: Distal gastrectomy was performed in 1185 patients (91.5%), proximal gastrectomy in 54 (4.2%), and total gastrectomy in 55 (4.3%); all were performed laparoscopically. The morbidity and mortality rates associated with these operations were 14.8% and 0%, respectively. Histologically, 1212 patients (93.7%) had stage iA disease, 75 (5.8%) had stage 113 disease, and 7 (0.5%) had stage II disease (the UICC staging). Cancer recurred in only 6 (0.6%) of 1294 patients treated curatively (median follow-up, 36 months; range, 13-113 months). The 5-year disease-free survival rate was 99.8% for stage IA disease, 98.7% for stage 113 disease, and 85.7% for stage II disease.Conclusions: Although our findings may be considered preliminary, our data indicate that laparoscopic surgery for EGC yields good short- and long-term oncologic outcomes.