腹腔镜下远端胃癌根治术联合区域淋巴结清扫术治疗胃癌。
Laparoscopic distal gastrectomy with regional lymph node dissection for gastric cancer.
作者信息
Tanimura S, Higashino M, Fukunaga Y, Kishida S, Nishikawa M, Ogata A, Osugi H
机构信息
Department of Gastroenterological Surgery, Osaka City General Hospital, 2-13-22, Miyakojimahondori Miyakojima-ku, Osaka, 534-0021 Japan.
出版信息
Surg Endosc. 2005 Sep;19(9):1177-81. doi: 10.1007/s00464-004-8936-4. Epub 2005 Jul 28.
BACKGROUND
Recent advances in surgical techniques have led to widespread acceptance of laparoscopic gastrectomy for gastric cancer. We performed distal gastrectomy with regional lymph node dissection in 235 patients with gastric cancer located in the middle and lower third of the stomach.
METHODS
In 171 cases, reconstruction was done using the Billroth I method intracorporeally and the aid of laparoscopic linear stapling devices. The Billroth II and Roux-en-Y methods were used in the remaining 56 and eight patients, respectively,
RESULTS
Patients who underwent laparoscopic distal gastrectomy had a more rapid postoperative recovery than those treated via the open approach. Postoperative complications with this technique were within a permissible range. In terms of the survival curve, there was no statistical difference between the laparoscopic group diagnosed as clinical T2N0 (c T2N0) Preoperatively and the open group.
CONCLUSION
The laparoscopic technique is not only less invasive, but is also similarly safe and curative compared to open gastrectomy.
背景
手术技术的最新进展已使腹腔镜胃癌切除术得到广泛认可。我们对235例位于胃中、下三分之一的胃癌患者进行了远端胃切除术及区域淋巴结清扫术。
方法
171例患者采用Billroth I法在体内进行重建，并借助腹腔镜线性缝合器。其余56例和8例患者分别采用Billroth II法和Roux-en-Y法。
结果
接受腹腔镜远端胃切除术的患者术后恢复比开腹手术患者更快。该技术的术后并发症在允许范围内。就生存曲线而言，术前诊断为临床T2N0（cT2N0）的腹腔镜组与开腹组之间无统计学差异。
结论
与开腹胃切除术相比，腹腔镜技术不仅创伤小，而且同样安全且具有治愈性。
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