腹腔镜胃癌根治术的长期疗效。
Long-term outcomes of laparoscopic gastrectomy for gastric cancer.
机构信息
Department of Gastric Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Center for Minimally Invasive Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
出版信息
J Surg Res. 2015 Jan;193(1):190-5. doi: 10.1016/j.jss.2014.07.040. Epub 2014 Jul 30.
BACKGROUND
Laparoscopic gastrectomy (LG) has been established as a procedure for the treatment of gastric cancer. However, there have been few reports on the long-term outcomes of LG for gastric cancer. The aim of this study is to investigate the long-term outcomes of LG for gastric cancer.
METHODS
A total of 278 consecutive patients who underwent LG in our unit between January 1999 and December 2006 were included in this study. Survival, recurrence, and late gastrointestinal complications were analyzed.
RESULTS
The median follow-up period was 73.7 mo (6-165 mo). Distal gastrectomy was performed in 229 patients, total gastrectomy in 23 patients, proximal gastrectomy in 15 patients, and pylorus-preserving gastrectomy in 11 patients. Five-year overall and disease-specific survival rates were 91% and 99% for stage IA, 75% and 91% for stage IB, 72% and 88% for stage II, and 40% and 50% for stage III, respectively. Recurrences were detected in 15 (5.4%) patients, including 5 distant lymph node, 5 peritoneal, 4 hematogenous, and 1 locoregional recurrences. Bowel obstruction occurred in 4 (1.4%) patients, and gallstones developed in 37 (15%) patients.
CONCLUSIONS
This follow-up investigation suggested that LG for gastric cancer is a feasible procedure from the standpoint of long-term oncological outcome and postoperative complications.
背景
腹腔镜胃切除术（LG）已被确立为治疗胃癌的一种方法。然而，关于 LG 治疗胃癌的长期疗效的报道很少。本研究旨在探讨 LG 治疗胃癌的长期疗效。
方法
本研究纳入了 1999 年 1 月至 2006 年 12 月期间在我院行 LG 的 278 例连续患者。分析了生存、复发和晚期胃肠道并发症。
结果
中位随访时间为 73.7 个月（6-165 个月）。远端胃切除术 229 例，全胃切除术 23 例，近端胃切除术 15 例，保留幽门的胃切除术 11 例。IA 期患者 5 年总生存率和疾病特异性生存率分别为 91%和 99%，IB 期分别为 75%和 91%，II 期分别为 72%和 88%，III 期分别为 40%和 50%。15 例（5.4%）患者出现复发，包括 5 例远处淋巴结、5 例腹膜、4 例血行和 1 例局部复发。4 例（1.4%）患者发生肠梗阻，37 例（15%）患者发生胆石症。
结论
从长期肿瘤学结果和术后并发症的角度来看，LG 治疗胃癌是一种可行的方法。
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