Tanimura S, Higashino M, Fukunaga Y, Takemura M, Tanaka Y, Fujiwara Y, Osugi H
Department of Gastroenterological Surgery, Osaka City General Hospital, 2-13-22, Miyakojimahondoori, Miyakojima-ku, Osaka, 534-0021, Japan.
Surg Endosc. 2008 May;22(5):1161-4. doi: 10.1007/s00464-008-9786-2. Epub 2008 Mar 6.
Among the less invasive operations noted in recent years, laparoscopic gastrectomy for gastric cancer has become popular because of advances in surgical techniques. The authors performed laparoscopic gastrectomy with regional lymph node dissection for 612 cases of gastric malignancies between March 1998 and August 2006. The technique and results of laparoscopic gastrectomy for gastric cancer are presented.
Of the 612 gastric malignancy cases, distal gastrectomy was performed in 485 cases, proximal gastrectomy in 42 cases, and total gastrectomy in 85 cases. In all the cases, D1 or D2 lymph node dissection was performed according to the general rule of the Japanese Gastric Cancer Association.
Quicker recovery was observed in the laparoscopic gastrectomy cases than in the open cases. The postoperative complications with this technique were within a permissible range. No statistical difference was seen in the survival curve after surgery between the laparoscopic group of advanced cases preoperatively diagnosed as surgical T2N1 or lower and the open group.
The laparoscopic technique is not only less invasive, but also similarly safe and curative compared with open gastrectomy.
在近年来出现的微创外科手术中,由于手术技术的进步,腹腔镜胃癌切除术已变得较为普及。作者于1998年3月至2006年8月期间,对612例胃恶性肿瘤患者实施了腹腔镜胃癌切除术并进行区域淋巴结清扫。本文介绍了腹腔镜胃癌切除术的技术及结果。
612例胃恶性肿瘤患者中,485例行远端胃切除术,42例行近端胃切除术,85例行全胃切除术。所有病例均按照日本胃癌协会的一般规则进行D1或D2淋巴结清扫。
腹腔镜手术病例的恢复速度比开腹手术病例更快。该技术的术后并发症在可允许范围内。术前诊断为外科T2N1或更低分期的进展期病例的腹腔镜组与开腹组术后生存曲线无统计学差异。
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根治性。