Feasibility of totally laparoscopic pylorus-preserving gastrectomy with intracorporeal gastro-gastrostomy for early gastric cancer: a retrospective cohort study
Feasibility of totally laparoscopic pylorus-preserving gastrectomy with intracorporeal gastro-gastrostomy for early gastric cancer: a retrospective cohort study
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DOI：
10.1186/s12957-020-01955-z
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发表时间：
2020-07-16
影响因子：
3.2
通讯作者：
Koeda, Keisuke
中科院分区：
文献类型：
--
作者：
Akiyama, Yuji;Sasaki, Akira;Koeda, Keisuke
背景保留幽门的胃切除术（PPG）在东亚国家已被公认为是治疗早期胃癌的一种保留功能的手术。因此，本研究的目的是评估的可行性和安全性，完全腹腔镜PPG（TLPPG）与intracardiac anastomosis.MethodsA共43例早期胃癌患者进行腹腔镜辅助PPG（LAPPG）与体外吻合2006年5月至2012年11月。对2012年11月至2019年2月期间接受TLPPG的22例患者的手术结果进行评估，并与LAPPG组的数据进行比较。TLPPG组的失血量（18.5 mL）低于LAPPG组（30.7 mL，p = 0.008），TLPPG组的腹部切口长度（3.8 cm）短于LAPPG组（4.7 cm，p < 0.001）。两组之间的并发症发生率无显著差异（TLPPG组为13.6%，LAPPG组为9.3%，p = 0.594）。两组均未发生与糖尿病相关的并发症。在胃排空延迟方面未观察到显著的组间差异（TLPPG，9.1 vs. LAPPG，7%，p = 0.762）。TLPPG组开始术后补液（TLPPG，1.0天vs. LAPPG，3.0天，p < 0.001）和进食（TLPPG，3.0天vs. LAPPG，4.0天，p < 0.001）的时间早于LAPPG组。术后住院时间无明显组间差异。ConclusionsThe研究结果表明，TLPPG与intracerebral重建不仅是可行的和安全的LAPPG治疗早期胃癌患者，但也提供了一定的优势，如减少失血量和伤口大小。
BackgroundPylorus-preserving gastrectomy (PPG) has been accepted as a function-preserving surgery for the treatment of early gastric cancer in East Asian countries. Therefore, this study aimed to evaluate the feasibility and safety of totally laparoscopic PPG (TLPPG) with intracorporeal anastomosis.MethodsA total of 43 patients with early gastric cancer underwent laparoscopy-assisted PPG (LAPPG) with extracorporeal anastomosis between May 2006 and November 2012. The operative outcomes of 22 patients who underwent TLPPG between November 2012 and February 2019 were evaluated, and data were compared with that of the LAPPG group.ResultsNo significant difference in the operative time was observed between the two groups. Blood loss was lower in the TLPPG group (18.5mL) than in the LAPPG group (30.7mL, p = 0.008), and the length of abdominal incision was shorter in the TLPPG group (3.8cm) than in the LAPPG group (4.7cm, p < 0.001). No significant difference in the complication rate was observed between the two groups (13.6% in the TLPPG vs. 9.3% in the LAPPG group, p = 0.594). No anastomosis-related complications occurred in either group. No significant between-group difference was observed in the delayed gastric emptying (TLPPG, 9.1 vs. LAPPG, 7%, p = 0.762). The initiation of postoperative fluid (TLPPG, 1.0day vs. LAPPG, 3.0days, p < 0.001) and meal (TLPPG, 3.0days vs. LAPPG, 4.0days, p < 0.001) intake was earlier in the TLPPG group than in the LAPPG group. No significant between-group difference was observed in the postoperative hospital stay.ConclusionsThe findings of this study suggest that TLPPG with intracorporeal reconstruction not only is as feasible and safe as LAPPG for the treatment of patients with early gastric cancer but also provides certain advantages such as reduced blood loss and wound size.