An Ji Yeong, Min Jae Seok, Lee Young Joon, Jeong Sang Ho, Hur Hoon, Han Sang Uk, Hyung Woo Jin, Cho Gyu Seok, Jeong Gui Ae, Jeong Oh, Park Young Kyu, Jung Mi Ran, Park Ji Yeon, Kim Young Woo, Yoon Hong Man, Eom Bang Wool, Ryu Keun Won
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Surgery, Dongnam Institute of Radiological and Medical Sciences, Cancer Center, Busan, Korea.
J Gastric Cancer. 2018 Mar;18(1):30-36. doi: 10.5230/jgc.2018.18.e6. Epub 2018 Mar 26.
We investigated complications after laparoscopic sentinel basin dissection (SBD) for patients with gastric cancer who were enrolled in a quality control study, prior to the phase III trial of sentinel lymph node navigation surgery (SNNS).
We analyzed prospective data from a Korean multicenter prerequisite quality control trial of laparoscopic SBD for gastric cancer and assessed procedure-related and surgical complications. All complications were classified according to the Clavien-Dindo Classification (CDC) system and were compared with the results of the previously published SNNS trial.
Among the 108 eligible patients who were enrolled in the quality control trial, 8 (7.4%) experienced complications during the early postoperative period. One patient with gastric resection-related duodenal stump leakage recovered after percutaneous drainage (grade IIIa in CDC). The other postoperative complications were mild and patients recovered with supportive care. No complications were directly related to the laparoscopic SBD procedure or tracer usage, and there were no mortalities. The laparoscopic SBD complication rates and patterns that were observed in this study were comparable to those of a previously reported trial.
The results of our prospective, multicenter quality control trial demonstrate that laparoscopic SBD is a safe procedure during SNNS for gastric cancer.
在进行前哨淋巴结导航手术(SNNS)的III期试验之前,我们对纳入质量控制研究的胃癌患者进行腹腔镜前哨区域清扫术(SBD)后的并发症进行了调查。
我们分析了韩国一项针对胃癌腹腔镜SBD的多中心前期质量控制试验的前瞻性数据,并评估了与手术相关的并发症和外科手术并发症。所有并发症均根据Clavien-Dindo分类(CDC)系统进行分类,并与先前发表的SNNS试验结果进行比较。
在纳入质量控制试验的108例符合条件的患者中,有8例(7.4%)在术后早期出现并发症。1例因胃切除相关的十二指肠残端漏,经经皮引流后康复(CDC分级为IIIa级)。其他术后并发症较轻,患者经支持治疗后康复。没有并发症与腹腔镜SBD手术或示踪剂使用直接相关,也没有死亡病例。本研究中观察到的腹腔镜SBD并发症发生率和类型与先前报道的试验相当。
我们的前瞻性多中心质量控制试验结果表明,在胃癌的SNNS期间,腹腔镜SBD是一种安全的手术。