Lee H J, Shiraishi N, Kim H H, Hiki N, Uyama I, Choi S H, Yang H K, Kitano S
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Korea.
Asian J Endosc Surg. 2012 Feb;5(1):5-11. doi: 10.1111/j.1758-5910.2011.00111.x. Epub 2011 Nov 24.
As the laparoscopic approach has become a popular gastric cancer treatment in Korea and Japan, the need for sharing current practices of surgeons who are experienced in laparoscopic gastric cancer surgery has increased.
We sent a questionnaire on laparoscopic instruments, image documentation, preoperative evaluation, surgical indication, operative methods, and postoperative management to laparoscopic experts in Korea and Japan, and 24 (14 from Korea and 10 from Japan) responded.
Endoscopic ultrasound and preoperative endoscopy-guided clipping are routinely employed, respectively, by 14 (58%) and 20 (83%) of the surgeons. Surgeons perform laparoscopy-assisted distal gastrectomy (LADG) based on varying indications. Five surgeons (21%) performed LADG only for cases of stage T1 cancer, 15 (63%) performed LADG on patients with less than T2 lesions, and 4 (17%) performed LADG on patients with less than T3 lesions. With regard to postoperative anastomosis, 18 surgeons (75%) preferred extracorporeal anastomosis and 6 (25%) preferred intracorporeal anastomosis. The mean postoperative hospital stay was 6.5 days in Korea and 10.1 days in Japan (P < 0.001).
This survey can help to inform the current practice of laparoscopic gastric cancer surgery in Korea and Japan, where laparoscopic surgery is frequently performed.
随着腹腔镜手术方法在韩国和日本成为一种流行的胃癌治疗方式，对于分享腹腔镜胃癌手术经验丰富的外科医生当前手术操作方法的需求日益增加。
我们向韩国和日本的腹腔镜专家发送了一份关于腹腔镜器械、图像记录、术前评估、手术指征、手术方法及术后管理的调查问卷，24人（14人来自韩国，10人来自日本）进行了回复。
14名（58%）外科医生常规采用内镜超声检查，20名（83%）常规采用术前内镜引导下钳夹术。外科医生基于不同指征实施腹腔镜辅助远端胃切除术（LADG）。5名外科医生（21%）仅对T1期癌症病例实施LADG，15名（63%）对T2期以下病变患者实施LADG，4名（17%）对T3期以下病变患者实施LADG。关于术后吻合方式，18名外科医生（75%）更倾向于体外吻合，6名（25%）更倾向于体内吻合。韩国术后平均住院时间为6.5天，日本为10.1天（P < 0.001）。
这项调查有助于了解韩国和日本腹腔镜胃癌手术的当前操作情况，在这两个国家腹腔镜手术应用频繁。
