Evaluation of the Safety and Feasibility of Laparoscopic Total Gastrectomy in Clinical Stage I Gastric Cancer Patients
Evaluation of the Safety and Feasibility of Laparoscopic Total Gastrectomy in Clinical Stage I Gastric Cancer Patients
复制标题
临床I期胃癌患者腹腔镜全胃切除术的安全性和可行性评价
DOI：
10.1007/s00268-015-3008-6
复制
发表时间：
2015
影响因子：
2.6
通讯作者：
E. Otsuji
中科院分区：
文献类型：
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作者：
D. Ichikawa;S. Komatsu;T. Kubota;K. Okamoto;H. Konishi;A. Shiozaki;H. Fujiwara;E. Otsuji
本研究旨在探讨临床I期胃癌患者行腹腔镜全胃切除术(LTG)的可行性，并验证在有经验的开腹外科医生中广泛采用LTG的适宜性。食道空肠吻合术采用左上腹部切开环形吻合器。结果除2例中转开放手术外，所有患者均成功完成了砧头固定置入(58例采用提升法，28例采用经口法)。经腹部左上象限小切口使用环形吻合器，为食道空肠吻合术平面提供了良好的腹腔镜视野。术后发生Clavien-Dindo分级II级及以上并发症14例，手术并发症发生率15.9%。本组无吻合口瘘发生。结论在临床I期胃癌患者中，有足够开腹胃切除经验的外科医生可以安全地施行腹腔镜全胃切除术，是一种不受医院容量影响的可行手术方式。
BackgroundThis retrospective study was designed to assess the feasibility of laparoscopic total gastrectomy (LTG) in clinical stage I gastric cancer patients, and validate the appropriateness of the widespread adoption of LTG for experienced open surgeons.MethodsEighty-eight patients with clinical stage I gastric cancer underwent LTG in our hospitals (n = 55) and affiliated hospitals (n = 33). Esophagojejunostomy was performed intracoporeally using a circular stapler with an incision in the left upper abdomen. We investigated the patients’ clinicopathologic factor, and evaluated the effect of hospital volume on short-term outcomes.ResultsFixed insertion of the anvil head was successfully achieved in all patients (lift-up method in 58 patients and transoral method in 28 patients), although 2 patients were converted to open surgery. The approach using a circular stapler through a small incision from the upper left quadrant of the abdomen facilitated a good laparoscopic visual field for the plane of the esophagojejunostomy. Fourteen patients developed Clavien–Dindo classification grade II or more postoperative complications, and the overall operative morbidity rate was 15.9 %. No anastomotic leakage was encountered in this series. No significant difference was observed in clinical outcomes between patients in the high- and low-volume hospital groups.ConclusionsLaparoscopic total gastrectomy can be performed safely on clinical stage I gastric cancer patients by surgeons with sufficient experience in open gastrectomy and therefore represents a feasible procedure that is not clinically impacted by hospital volume.
影响因子：
3.8
作者：
Nagai, Eishi;Ohuchida, Kenoki;Tanaka, Masao
通讯作者：
Tanaka, Masao
影响因子：
9
作者：
Kitano, Seigo;Shiraishi, Norio;Tanigawa, Nobuhiko
通讯作者：
Tanigawa, Nobuhiko
影响因子：
7.4
作者：
通讯作者：
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