Complete mesogastric excision for locally advanced gastric cancer: short-term outcomes of a randomized clinical trial.
Complete mesogastric excision for locally advanced gastric cancer: short-term outcomes of a randomized clinical trial.
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完全胃系膜切除术治疗局部晚期胃癌：随机临床试验的短期结果
DOI：
10.1016/j.xcrm.2021.100217
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发表时间：
2021-03-16
期刊：
影响因子：
--
通讯作者：
Gong J
中科院分区：
文献类型：
--
作者：
Xie D;Shen J;Liu L;Cao B;Wang Y;Qin J;Wu J;Yan Q;Hu Y;Yang C;Cao Z;Hu J;Yin P;Gong J
在胃癌手术中实施完全胃系膜切除术，称为D2淋巴结切除术加完全胃系膜切除术（D2+CME），最近被认为是一种最佳的手术方式。然而，D2+CME的安全性和有效性仍不确定。在这项随机对照试验中，接受D2+CME的患者与接受传统D2根治术的患者相比，术中失血量更少，淋巴结收获更多，术后排气更早。单变量考克斯回归分析显示，D2+CME组术后排气的风险比为1.247（p = 0.044）。两组的总体术后并发症相当，但D2+CME组的并发症严重程度显著低于D2组（Clavien-Dindo分级≥ IIIa级：4例D2+CME患者[11.8%] vs 9例D2患者[33.3%]; p = 0.041）。总之，我们的工作表明，D2+CME与进展期胃癌患者的传统D2剥离相比，具有更好的短期结局和手术安全性。D2 +CME组胃癌患者术中出血量少，淋巴结清扫数明显增加，术后排气快，D2 + CME组术后严重并发症少。Xie et al.证明了在胃癌患者中名为D2+CME的外科手术的短期结果。他们将D2+CME与传统的D2根治性手术进行了比较，结果表明D2+CME具有更好的结局和手术安全性。这为胃癌患者提供了一种最佳的手术方法。
Implementation of complete mesogastric excision in gastric cancer surgery, named D2 lymphadenectomy plus complete mesogastric excision (D2+CME), has recently been proposed as an optimal procedure. However, the safety and efficacy of D2+CME remain uncertain. In this randomized controlled trial, patients receiving D2+CME exhibit less intraoperative blood loss, more lymph node harvesting, and earlier postoperative flatus than patients receiving conventional D2 radical surgery. Univariate Cox regression analysis reveals that the risk ratio for postoperative flatus in D2+CME group is 1.247 (p = 0.044). Overall postoperative complications are comparable between the two groups, but complications are significantly less severe in the D2+CME group than the D2 group (Clavien-Dindo classification grade ≥ IIIa: 4 D2+CME patients [11.8%] versus 9 D2 patients [33.3%]; p = 0.041). In conclusion, our work shows that D2+CME is associated with better short-term outcomes and surgical safety than conventional D2 dissection for patients with advanced gastric cancer. Gastric cancer patients receiving D2+CME exhibit less intraoperative blood loss The number of lymph nodes harvested with D2+CME is significantly improved D2+CME surgery could provide faster postoperative flatus D2+CME is less likely to cause severe complications than conventional surgery Xie et al. demonstrate the short-term outcomes of a surgical procedure named D2+CME in gastric cancer patients. They compare D2+CME with conventional D2 radical surgery and show that D2+CME has better outcomes and surgical safety. This provides an optimal surgical approach for patients with gastric cancer.
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影响因子：
2.5
作者：
Shen J;Cao B;Wang Y;Xiao A;Qin J;Wu J;Yan Q;Hu Y;Yang C;Cao Z;Hu J;Yin P;Xie D;Gong J
通讯作者：
Gong J
影响因子：
120.7
作者：
Yu, Jiang;Huang, Changming;Wang, Baolin
通讯作者：
Wang, Baolin
胃系膜：胃癌的第五种转移途径？
影响因子：
4.7
作者：
Xie, Daxing;Osaiweran, Hasan;Gong, Jianping
通讯作者：
Gong, Jianping
影响因子：
3.4
作者：
Hohenberger, W.;Weber, K.;Merkel, S.
通讯作者：
Merkel, S.
腹腔镜D2淋巴结清扫术联合胃系膜完全切除治疗晚期胃癌的短期疗效
DOI：
10.1007/s00464-016-4847-4
发表时间：
2016-11-01
影响因子：
3.1
作者：
Xie, Daxing;Yu, Chaoran;Gong, Jianping
通讯作者：
Gong, Jianping