Curability of laparoscopic gastrectomy for gastric cancer: an analysis of 10 years’ experience
Curability of laparoscopic gastrectomy for gastric cancer: an analysis of 10 years’ experience
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腹腔镜胃切除术治疗胃癌的治愈率：10年经验分析
DOI：
10.1007/s10120-008-0478-3
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发表时间：
2008
期刊：
影响因子：
7.4
通讯作者：
Sang
中科院分区：
文献类型：
--
作者：
Xiaoqiao Zhang;N. Tanigawa;E. Nomura;Sang
研究背景腹腔镜胃切除术正被广泛应用于胃癌的治疗。为了评价其在肿瘤学上的可行性，我们根据10年来的经验，分析了腹腔镜胃切除术的可行性。方法对近10年来所有行腹腔镜胃癌切除术的病例进行分析。分析和比较不同术式的淋巴结清扫数、原发灶与切除线之间的近、远距离。结果在391例符合条件的患者中，大部分患者符合当前治疗指南的肿瘤学要求。近、远端平均距离分别为3.73±2.11 cm和5.31±3.26 cm。近端距离<1 cm者10例，远端者5例，病理检查均为阴性。平均每次清扫22个淋巴结，平均(21.7±12.1)个。在淋巴清扫方面，腹腔镜D2切除术与开腹手术具有相同的能力。开腹手术的近端距离比腹腔镜组长约1 cm(4.99±2.59 cmvs4.06±1.87 cm；P=0.038)，远端距离差异无统计学意义(6.94±3.52 cmvs7.24±4.64 cm；P=0.187)。
BackgroundLaparoscopic gastrectomy is becoming widely used for the management of gastric cancer. To evaluate its oncologic feasibility, we analyzed the curability of laparoscopic gastrectomy based on our 10-year experience.MethodsAll laparoscopic gastrectomies for gastric cancer performed in the past 10 years, with the exception of those converted to open surgery, were evaluated. The number of dissected lymph nodes and the proximal and distal distances between the primary lesion and resection lines were analyzed and compared among different procedures. Laparoscopic and open D2 resection were also compared.ResultsMost of the 391 eligible patients fulfilled the oncologic requirement of current treatment guidelines. The mean proximal and distal distances were 3.73 ± 2.11 cm and 5.31 ± 3.26 cm, respectively. A distance of less than 1 cm occurred in only 10 patients proximally and 5 patients distally, with pathological examination results being negative. In each operation, an average of 22 lymph nodes were dissected (21.7 ± 12.1). Laparoscopic D2 resection possessed the same capacity as open surgery in terms of lymph node dissection. The proximal distance in open surgery was about 1 cm longer than that in laparoscopic gastrectomy (4.99 ± 2.59 cm vs 4.06 ± 1.87 cm;P= 0.038), while the difference between distal distances was not significant (6.94 ± 3.52 cm vs 7.24 ± 4.64 cm;P= 0.187).ConclusionFrom the point of view of curability, laparoscopic operation is an oncologically safe procedure for the management of gastric cancer, at least for stage I and II disease.
影响因子：
9
作者：
Kitano, Seigo;Shiraishi, Norio;Tanigawa, Nobuhiko
通讯作者：
Tanigawa, Nobuhiko