腹腔镜辅助胃癌根治术治疗进展期胃癌的长期疗效：106 例连续病例分析。
Long-term outcomes after laparoscopy-assisted gastrectomy for advanced gastric cancer: analysis of consecutive 106 experiences.
机构信息
Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
出版信息
J Surg Oncol. 2009 Dec 15;100(8):693-8. doi: 10.1002/jso.21400.
BACKGROUND AND OBJECTIVES
The purpose of this retrospective study is to suggest the possibility of laparoscopy-assisted gastrectomy (LAG) for advanced gastric cancer (AGC) through long-term outcomes.
METHODS
Of 283 patients with gastric cancer who underwent LAG with extraperigastric (D2) lymphadenectomy between January 2004 and February 2009, 106 were pathologically confirmed with AGC and analyzed.
RESULTS
There were 75 men and 31 women, with a mean age of 61.4 +/- 11.7 years. There were 32 total gastrectomies and 74 distal gastrectomies with D2 lymphadenectomy. The mean tumor size was 4.8 +/- 2.6 cm. The mean numbers of retrieved and metastatic lymph nodes were 34.3 +/- 15.3 and 5.4 +/- 8.7, respectively. There was no lymph node metastasis in 44 patients (41.5%), and there were 35 grade T2a, 51 T2b, and 20 T3 lesions. There were 10 operation-related morbidities (9.4%) and one postoperative death (0.9%) from hepatic failure. The overall and disease-free survival rates were 81.4% and 72.4%, respectively. Tumors recurred in 17 patients (16.0%) during the follow-up periods (median 21.5 months; range 2-60).
CONCLUSIONS
LAG for AGC might be considered as a minimally invasive treatment in selected cases, but further study comparing it with open gastrectomy will be needed.
背景与目的
本回顾性研究旨在通过长期结果，提出腹腔镜辅助胃切除术（LAG）治疗进展期胃癌（AGC）的可能性。
方法
2004 年 1 月至 2009 年 2 月期间，283 例接受 LAG 联合胃外（D2）淋巴结清扫术的胃癌患者中，106 例病理证实为 AGC 并进行了分析。
结果
男 75 例，女 31 例，平均年龄 61.4±11.7 岁。32 例全胃切除术，74 例远端胃切除术伴 D2 淋巴结清扫术。肿瘤平均大小为 4.8±2.6cm。平均检出和转移淋巴结数分别为 34.3±15.3 和 5.4±8.7。44 例（41.5%）无淋巴结转移，T2a 35 例，T2b51 例，T320 例。10 例（9.4%）手术相关并发症，1 例（0.9%）术后肝功能衰竭死亡。总生存率和无病生存率分别为 81.4%和 72.4%。随访期间 17 例（16.0%）肿瘤复发，中位随访时间 21.5 个月（范围 2-60）。
结论
对于选择性病例，LAG 治疗 AGC 可作为一种微创治疗方法，但需要进一步比较其与开放性胃切除术的研究。
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