Lu Jun, Huang Chang-Ming, Zheng Chao-Hui, Li Ping, Xie Jian-Wei, Wang Jia-Bin, Lin Jian-Xian
Department of Gastric Surgery, Affiliated Union Hospital of Fujian Medical University, Fuzhou, China.
Hepatogastroenterology. 2013 Mar-Apr;60(122):296-300. doi: 10.5754/hge12641.
BACKGROUND/AIMS: To investigate the learning curve of laparoscopy spleen-preserving splenic hilar lymph node dissection for advanced upper gastric cancer (AUGC).
A retrospective analysis of clinical data of 100 cases of spleen-preserving splenic hilar lymph node dissection for AUGC, completed by the same group of physicians with extensive laparoscopic gastric cancer surgical experience. The patients were divided into five groups (A, B, C, D and E) in accordance with their surgical priorities.
The five groups of patients were comparable in age, gender, body mass index, spleen lobe artery count, histological type and invasion department. The surgical time for Group A and Group B was longer than Group C, Group D and Group E. The amount of bleeding for Group A and Group B was significantly larger than Group C, Group D and Group E. Laparotomy rate, the number of splenic hilar lymph node dissection, incidence of complications, recovery time of bowel function, days for postoperative hospital stay were not statistically different among the five groups.
On the basis of skilled surgical techniques for laparoscopic gastric cancer, the learning curve for laparoscopy spleen-preserving splenic hilar lymph node dissection for upper advanced gastric cancer was roughly 40 cases.
背景/目的：探讨进展期上部胃癌（AUGC）腹腔镜保留脾脏脾门淋巴结清扫术的学习曲线。
回顾性分析由同一组具有丰富腹腔镜胃癌手术经验的医生完成的100例AUGC保留脾脏脾门淋巴结清扫术的临床资料。根据手术先后顺序将患者分为五组（A、B、C、D和E组）。
五组患者在年龄、性别、体重指数、脾叶动脉数量、组织学类型和侵犯部位方面具有可比性。A组和B组的手术时间长于C组、D组和E组。A组和B组的出血量显著多于C组、D组和E组。五组间剖腹手术率、脾门淋巴结清扫数量、并发症发生率、肠功能恢复时间、术后住院天数差异无统计学意义。
在熟练掌握腹腔镜胃癌手术技术的基础上，进展期上部胃癌腹腔镜保留脾脏脾门淋巴结清扫术的学习曲线约为40例。
