Department of Surgery and Oncology, Graduate School of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
Surg Today. 2013 Aug;43(8):859-64. doi: 10.1007/s00595-012-0338-y. Epub 2012 Sep 16.
The role of gastrectomy for patients with positive peritoneal cytology, but a negative macroscopic peritoneal implant (P-/cy+), remains unclear. The aim of this study was to evaluate laparoscopic gastrectomy for P-/cy+ patients.
This study reviewed a prospectively maintained gastric cancer database of gastric-cancer patients those underwent surgical resection. P-/cy+ gastric cancer that had invaded the subserosa, or deeper layers, of the stomach wall without distant organ metastases was considered operable in this institution. P-/cy+ patients underwent either open or laparoscopic gastrectomy with D2 lymphadenectomy. The short-term results were examined to assess differences in outcome between the two groups.
Eighteen P-/cy+ patients without distant organ metastases underwent surgery between 2000 and 2010. Laparoscopic gastrectomy was performed in nine patients and open gastrectomy in nine patients. The estimated blood loss was significantly smaller, the resumption of food intake earlier, and the length of postoperative hospital stay shorter in the patients that underwent laparoscopic gastrectomy than in the patients that underwent open gastrectomy. There were no significant differences in the 2-year survival rates between the groups.
Laparoscopic gastrectomy for P-/cy+ patients is a minimally invasive and safe oncologic procedure with good short-term results.
对于腹膜细胞学阳性但宏观腹膜种植阴性（P-/cy+）的患者，胃切除术的作用仍不清楚。本研究旨在评估腹腔镜胃切除术对 P-/cy+患者的疗效。
本研究回顾性分析了一家机构接受手术切除的胃癌患者的前瞻性胃癌数据库。在该机构中，被认为具有手术治疗指征的 P-/cy+胃癌是指侵犯胃壁浆膜下层或更深层且无远处器官转移的胃癌。P-/cy+患者行腹腔镜或开放性胃癌根治术+D2 淋巴结清扫术。检查短期结果，以评估两组之间的治疗效果差异。
2000 年至 2010 年间，18 例无远处器官转移的 P-/cy+患者接受了手术治疗。9 例患者行腹腔镜胃切除术，9 例患者行开放性胃切除术。与开放性胃切除术相比，腹腔镜胃切除术的估计出血量更少，术后首次进食时间更早，术后住院时间更短。两组患者的 2 年生存率无显著差异。
对于 P-/cy+患者，腹腔镜胃切除术是一种微创且安全的肿瘤治疗方法，具有良好的短期疗效。
