Li You, Zang Lu, Hu Wei-guo, Wang Ming-liang, Lu Ai-guo, Li Jian-wen, Ma Jun-jun, Feng Bo, Jiang Yu, Wu Yun-lin, Zhu Zheng-gang, Zheng Min-hua
Department of Surgery, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2010 Dec;13(12):899-902.
To evaluate laparoscopic radical gastrectomy for early gastric cancer.
A total of 204 patients with early gastric cancer undergoing laparoscopic-assisted radical gastrectomy or open radical gastrectomy between October 2004 and December 2009 were retrospectively reviewed and analyzed. Patients were divided into laparoscopic group(LAP, n=78) and open group (OPEN, n=126). Operative time, blood loss, time to passage of flatus, postoperative hospital stay, complications and pathologic findings were compared between the two groups.
Compared to the OPEN group, operative time in the LAP group was significantly shorter[(202.9±45.6) min vs.(219.8±45.2) min, P<0.05], blood loss was less[(144.5±146.5) ml vs. (245.0±146.4) ml, P<0.05], time to passage of flatus was shorter[(3.1±1.1) d vs.(4.5±1.6) d, P<0.05], postoperative hospital stay was shorter[(10.8±1.2) d vs. (12.4±3.8) d, P<0.05]. However, the two groups were comparable with regard to postoperative complication rate(10.3% vs. 12.7%, P>0.05), proximal resection margin[(4.0±1.9) cm vs. (4.2±1.7) cm, P>0.05], distal resection margin [(3.6±1.7) cm vs. (3.5±1.8) cm, P>0.05], number of harvested lymph node(13.1±6.5 vs. 14.5±8.2, P>0.05). The median follow up was 22(2-64) months. There were no tumor recurrences or metastases in the LAP group. In the OPEN group, only 1 patient died from peritoneal metastasis. Total hospital costs between the two groups were similar(P>0.05).
Laparoscopic radical gastrectomy is a safe, feasible, effective, and less invasive surgery for early gastric cancer.
评估腹腔镜根治性胃癌切除术治疗早期胃癌的效果。
回顾性分析2004年10月至2009年12月期间接受腹腔镜辅助根治性胃癌切除术或开放根治性胃癌切除术的204例早期胃癌患者。患者分为腹腔镜组（LAP，n = 78）和开放组（OPEN，n = 126）。比较两组患者的手术时间、出血量、排气时间、术后住院时间、并发症及病理结果。
与开放组相比，腹腔镜组手术时间明显缩短[（202.9±45.6）分钟 vs.（219.8±45.2）分钟，P < 0.05]，出血量更少[（144.5±146.5）毫升 vs.（245.0±146.4）毫升，P < 0.05]，排气时间更短[（3.1±1.1）天 vs.（4.5±1.6）天，P < 0.05]，术后住院时间更短[（10.8±1.2）天 vs.（12.4±3.8）天，P < 0.05]。然而，两组术后并发症发生率（10.3% vs. 12.7%，P > 0.05）、近端切缘[（4.0±1.9）厘米 vs.（4.2±1.7）厘米，P > 0.05]、远端切缘[（3.6±1.7）厘米 vs.（3.5±1.8）厘米，P > 0.05]、清扫淋巴结数目（13.1±6.5 vs. 14.5±8.2，P > 0.05）比较差异无统计学意义。中位随访时间为22（2 - 64）个月。腹腔镜组无肿瘤复发或转移。开放组仅1例患者死于腹膜转移。两组总住院费用相似（P > 0.05）。
腹腔镜根治性胃癌切除术治疗早期胃癌安全、可行、有效且创伤较小。
