胃癌手术中模块化淋巴结清扫的三步法：获取足够数量淋巴结及提高生存率的能力
A three-step method for modular lymphadenectomy in gastric cancer surgery: The ability to retrieve sufficient lymph nodes and improve survival.
作者信息
Li Maolan, Wang Xu-An, Wang Lei, Wu Xiangsong, Wu Wenguang, Song Xiaoling, Zhao Shuai, Zhang Fei, Ma Qiang, Liang Haibin, Xiang Shanshan, Wang Zheng, Gong Wei, Dong Ping, Liu Yingbin
机构信息
Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Research Center of Biliary Tract Disease, Shanghai, China.
Department of Hepatobiliary Surgery, Nanjing Medical University Affiliated Wuxi No2 Hospital, Jiangsu, China.
出版信息
Am J Surg. 2018 Jan;215(1):91-96. doi: 10.1016/j.amjsurg.2017.01.042. Epub 2017 Apr 7.
BACKGROUND
Systematic lymphadenectomy for the resection of sufficient lymph nodes is the most important part of curative resection in gastric cancer surgery. Here, we explore the outcomes of the three-step method for modular lymphadenectomy (TSMML) and determine its safety and efficacy, compared with the conventional method for lymphadenectomy (CML).
METHODS
From 2008 to 2011, 270 patients with gastric cancer were divided into 2 subgroups: the TSMML group and the CML group.
RESULTS
Patients in the TSMML group had a significantly higher median number of retrieved lymph nodes (rLNs), lower median metastatic lymph node ratios (MLRs), and superior 5-year relapse-free survival (RFS) than the CML group. Moreover, the use of the TSMML procedure was an independent protective factor for RFS. No significant intergroup differences were found in morbidity or mortality in these two groups.
CONCLUSION
The TSMML procedure is safe and effective and is easy to learn.
背景
系统性淋巴结清扫以切除足够数量的淋巴结是胃癌手术根治性切除的最重要部分。在此，我们探讨模块化淋巴结清扫三步法（TSMML）的效果，并与传统淋巴结清扫方法（CML）相比，确定其安全性和有效性。
方法
2008年至2011年，270例胃癌患者被分为两个亚组：TSMML组和CML组。
结果
TSMML组患者的中位淋巴结回收数（rLNs）显著更高，中位转移淋巴结比率（MLRs）更低，5年无复发生存率（RFS）优于CML组。此外，TSMML手术的应用是RFS的独立保护因素。两组在发病率或死亡率方面未发现显著的组间差异。
结论
TSMML手术安全有效且易于学习。
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