Laparoscopy-assisted gastrectomy with D2 lymph node dissection for advanced gastric cancer without serosa invasion: a matched cohort study from South China.
Laparoscopy-assisted gastrectomy with D2 lymph node dissection for advanced gastric cancer without serosa invasion: a matched cohort study from South China.
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DOI：
10.1186/1477-7819-11-4
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发表时间：
2013-01-11
影响因子：
3.2
通讯作者：
Lu J
中科院分区：
文献类型：
--
作者：
Lin JX;Huang CM;Zheng CH;Li P;Xie JW;Wang JB;Lu J
胃癌是世界范围内常见的恶性肿瘤，也是癌症死亡的常见原因。尽管最近在多模态治疗和靶向治疗方面取得了进展，但完全切除仍然是唯一可以治愈的治疗方法。本研究旨在探讨腹腔镜辅助下无浆膜浸润进展期胃癌切除术的技术可行性、安全性和肿瘤学疗效。在中国南方进行了一项回顾性配对队列研究，比较腹腔镜辅助胃切除术和开放胃切除术治疗无浆膜浸润的进展期胃癌。入组了2008年1月至2010年12月期间接受腹腔镜辅助胃切除术的83例晚期胃癌患者。这些患者与同期行开放胃切除术的83例进展期胃癌患者进行了比较。两组间临床病理特征无显著差异。在围手术期特征方面，两组的手术时间和下地活动时间无差异，而腹腔镜辅助胃切除术的失血量、输血患者数量、首次排气时间、恢复饮食时间和术后住院时间均显著少于开腹胃切除术（P <0.05）。术后发病率和死亡率无统计学显著差异。两组间淋巴结清扫数量无显著差异。两组的累积生存率无显著差异。腹腔镜辅助下胃切除D2淋巴结清扫术是治疗无浆膜浸润的进展期胃癌的一种安全可行的术式。为了被接受为进展期胃癌的一种选择性治疗方法，设计良好的随机对照试验比较腹腔镜辅助胃切除术和开放胃切除术在更大数量的患者之间的短期和长期结果是必要的。
Gastric cancer is a common malignancy worldwide and a common cause of death from cancer. Despite recent advances in multimodality treatment and targeted therapy, complete resection remains the only treatment that can lead to cure. This study was devised to investigate the technical feasibility, safety and oncologic efficacy of laparoscopy-assisted gastrectomy for advanced gastric cancer without serosa invasion. A retrospective matched cohort study was performed in south China comparing laparoscopy-assisted gastrectomy and open gastrectomy for advanced gastric cancer without serosa invasion. Eighty-three patients with advanced gastric cancer undergoing laparoscopy-assisted gastrectomy between January 2008 and December 2010 were enrolled. These patients were compared with 83 patients with advanced gastric cancer undergoing open gastrectomy during the same period. There was no significant difference in clinicopathologic characteristics between the two groups. Regarding perioperative characteristics, the operation time and time to ground activities did not differ between the two groups, whereas the blood loss, transfused patient number, time to first flatus, time to resumption of diet, and postoperative hospital stay were significantly less in laparoscopy-assisted gastrectomy than in open gastrectomy (P <0.05). There was no statistically significant difference in postoperative morbidity and mortality. No significant difference in the number of lymph nodes dissected was observed between these two groups. There was no significant difference in the cumulative survival rate between the two groups. Laparoscopy-assisted gastrectomy with D2 lymphadenectomy is a safe and feasible procedure for advanced gastric cancer without serosa invasion. To be accepted as a choice treatment for advanced gastric cancer, well-designed randomized controlled trials comparing short-term and long-term outcomes between laparoscopy-assisted gastrectomy and open gastrectomy in a larger number of patients are necessary.
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影响因子：
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作者：
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通讯作者：
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DOI：
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DOI：
10.1007/s00464-008-0198-0
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2009-08-01
影响因子：
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作者：
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