Goto Hironobu, Yasuda Takashi, Oshikiri Taro, Kanaji Shingo, Kawasaki Kentaro, Imanishi Tatsuya, Oyama Masato, Kakinoki Keitaro, Ohara Tadayuki, Sendo Hiroyoshi, Fujino Yasuhiro, Tominaga Masahiro, Kakeji Yoshihiro
Division of Gastroenterological Surgery, Hyogo Cancer Center, Akashi, Japan.
Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan.
Asian J Endosc Surg. 2016 May;9(2):116-21. doi: 10.1111/ases.12269. Epub 2016 Jan 25.
Laparoscopic distal gastrectomy (LDG) with D1+ lymph node dissection (LND) for early gastric cancer has been widely accepted. However, LDG with D2 LND for advanced gastric cancer remains in limited use. The aim of this retrospective study was to clarify the safety of LDG with D2 LND for gastric cancer.
From January 2010 to September 2014, 296 patients underwent LDG; those who received D1+ LND (n = 230) or D2 LND (n = 66) were included in this study. The clinicopathological characteristics and short-term outcomes of both groups were investigated and compared.
There were no significant differences in the incidence of postoperative complications between the two groups. However, the frequency of infectious intra-abdominal complications was higher in the D2 LND group than in the D1+ LND group. Additionally, a lower risk of infectious intra-abdominal complications was seen with certified than with uncertified operators.
The evaluation of short-term outcomes demonstrated that LDG with D2 LND is generally feasible. However, the risk of infectious intra-abdominal complications is higher with D2 LND than with D1+ LND. Also, D2 LND should be performed by trained operators.
腹腔镜远端胃癌切除术（LDG）联合D1+淋巴结清扫术（LND）治疗早期胃癌已被广泛接受。然而，LDG联合D2淋巴结清扫术治疗进展期胃癌的应用仍然有限。本回顾性研究的目的是阐明LDG联合D2淋巴结清扫术治疗胃癌的安全性。
2010年1月至2014年9月，296例患者接受了LDG；本研究纳入了接受D1+淋巴结清扫术（n = 230）或D2淋巴结清扫术（n = 66）的患者。对两组患者的临床病理特征和短期结局进行了调查和比较。
两组术后并发症发生率无显著差异。然而，D2淋巴结清扫术组腹腔内感染性并发症的发生率高于D1+淋巴结清扫术组。此外，与未经认证的术者相比，经认证的术者发生腹腔内感染性并发症的风险更低。
短期结局评估表明，LDG联合D2淋巴结清扫术总体上是可行的。然而，D2淋巴结清扫术发生腹腔内感染性并发症的风险高于D1+淋巴结清扫术。此外，D2淋巴结清扫术应由经过培训的术者进行。
