Lee J-H, Han H-S, Lee J-H
Department of Surgery, Ewha Woman's University College of Medicine, Seoul, Korea.
Surg Endosc. 2005 Feb;19(2):168-73. doi: 10.1007/s00464-004-8808-y. Epub 2004 Dec 9.
We conducted a prospective randomized trial to compare laparoscopy-assisted distal gastrectomy (LADG) including lymphadenectomy with open distal gastrectomy for the management of early gastric cancer (EGC).
Forty-seven patients who had been diagnosed endoscopically with EGC were included in a study that ran from November 2001 to August 2003. With the aid of random number table, 23 patients were assigned to the open group (group O) and 24 patients were assigned to the LADG group (group L).
Estimated blood loss and transfusion amounts were similar in the two groups. The mean postoperative hospital stay and the duration of analgesic administration were shorter for group L but not significantly so. The mean number of harvested lymph nodes was 38.1 in the O group and 31.8 in the L group (p = 0.098). Postoperative pulmonary complications occurred more frequently in the O group (p = 0.043). At a median follow-up of 14 months, there has been no recurrence of disease in either group.
In terms of resulting in fewer pulmonary complications while maintaining the curability of EGC, LADG has a clear advantage over its open counterpart.
我们进行了一项前瞻性随机试验,比较腹腔镜辅助远端胃癌切除术(LADG)(包括淋巴结清扫)与开放性远端胃癌切除术治疗早期胃癌(EGC)的效果。
2001年11月至2003年8月期间,47例经内镜诊断为EGC的患者纳入本研究。借助随机数字表,23例患者被分配至开放手术组(O组),24例患者被分配至LADG组(L组)。
两组的估计失血量和输血量相似。L组的术后平均住院时间和镇痛给药时间较短,但差异无统计学意义。O组平均获取淋巴结数为38.1枚,L组为31.8枚(p = 0.098)。O组术后肺部并发症发生率更高(p = 0.043)。中位随访14个月时,两组均无疾病复发。
在减少肺部并发症同时保持EGC可治愈性方面,LADG较开放性手术具有明显优势。