Fang Cheng, Hua Jin, Li Jipeng, Zhen Jianyong, Wang Fei, Zhao Qingchuan, Shuang Jianbo, Du Jianjun
Department of Surgery, Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, No. 127 Changle West Road, Xian 710032, China.
Department of Surgery, Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, No. 127 Changle West Road, Xian 710032, China.
Am J Surg. 2014 Sep;208(3):391-6. doi: 10.1016/j.amjsurg.2013.09.028. Epub 2014 Jan 16.
The aim of this study was to compare surgical outcomes and oncologic efficacy of laparoscopy-assisted gastrectomy (LAG) versus open gastrectomy (OG) for advanced gastric cancer.
For this study, 87 consecutive advanced gastric cancer (AGC) patients who underwent LAG with D2 lymph node dissection between April 2005 and October 2009 were enrolled, compared with 87 AGC patients who underwent OG during the same period.
Operative procedure and surgical margin were similar between the 2 groups. The operative time was significantly longer in the LAG group than the OG group, while the estimated blood loss was significantly less in the LAG group. There were no significant differences in postoperative complications and in the number of lymph nodes retrieved. The use of analgesic drugs was significantly less after LAG. Length of postoperative stay was significantly shorter in the LAG group. The 5-year overall survival rate and recurrence-free survival rate were comparative between the 2 groups.
This 5-year case-control study presented that laparoscopy-assisted gastrectomy may be a safe and acceptable procedure in terms of long-term results for AGC.
本研究旨在比较腹腔镜辅助胃癌切除术（LAG）与开腹胃癌切除术（OG）治疗进展期胃癌的手术效果及肿瘤学疗效。
本研究纳入了2005年4月至2009年10月期间连续87例行LAG联合D2淋巴结清扫术的进展期胃癌（AGC）患者，并与同期87例行OG的AGC患者进行比较。
两组患者的手术方式和手术切缘相似。LAG组的手术时间显著长于OG组，而LAG组的估计失血量显著较少。术后并发症及获取的淋巴结数量无显著差异。LAG术后使用镇痛药的情况显著减少。LAG组的术后住院时间显著缩短。两组的5年总生存率和无复发生存率具有可比性。
这项为期5年的病例对照研究表明，就AGC的长期结果而言，腹腔镜辅助胃癌切除术可能是一种安全且可接受的手术方式。
