Department of General Surgery, Chinese PLA General Hospital, China.
Department of Endoscopic Surgery, Chinese PLA 451st Hospital, China.
J Surg Oncol. 2018 Dec;118(8):1264-1270. doi: 10.1002/jso.25262. Epub 2018 Oct 31.
We compared the clinical outcomes of laparoscopic and open spleen-preserving splenic hilar lymphadenectomy (LSPL and OSPL) for gastric cancer.
We performed a single-center, randomized, controlled trial to compare the short-term surgical outcomes between LSPL and OSPL. The study was registered in ClinicalTrials.gov (NCT02980861).
A total of 222 patients were enrolled (114 in the LSPL group and 108 in the OSPL group). There were no significant differences between the two groups in operative time (P = 0.152), a number of harvested lymph nodes (P = 0.669) including no. 10 lymph nodes (2.1 ± 1.4 vs 2.3 ± 1.2, P = 0.713). The time taken for no. 10 lymph node dissection was similar in both groups (13.9 ± 10.4 vs 15.2 ± 9.4 minutes, P = 0.217); however, the LSPL group experienced less total blood loss (P < 0.001) and less blood loss during no. 10 lymph node dissection compared with the OSPL group (15.3 ± 37.8 vs 29.5 ± 36.4 mL, P < 0.001). The postoperative complication rates of LSPL and OSPL were 18.3% and 16.1%, respectively (P = 0.331).
LSPL is a safe and feasible surgical procedure in no. 10 LN dissection for patients with advanced proximal gastric cancer. Thus, this prospective trial is continuing.
我们比较了腹腔镜保脾脾门淋巴结清扫术(LSPL 和 OSPL)治疗胃癌的临床疗效。
我们进行了一项单中心、随机、对照试验,比较了 LSPL 和 OSPL 两种术式的短期手术结果。该研究已在 ClinicalTrials.gov 注册(NCT02980861)。
共纳入 222 例患者(LSPL 组 114 例,OSPL 组 108 例)。两组的手术时间(P = 0.152)、清扫的淋巴结数量(P = 0.669)包括第 10 组淋巴结(2.1 ± 1.4 vs 2.3 ± 1.2,P = 0.713)均无显著差异。两组第 10 组淋巴结清扫时间相似(13.9 ± 10.4 vs 15.2 ± 9.4 分钟,P = 0.217);但 LSPL 组总出血量(P < 0.001)和第 10 组淋巴结清扫时出血量(P < 0.001)均少于 OSPL 组(15.3 ± 37.8 vs 29.5 ± 36.4 毫升)。LSPL 和 OSPL 的术后并发症发生率分别为 18.3%和 16.1%(P = 0.331)。
LSPL 是治疗进展期近端胃癌患者第 10 组淋巴结的安全可行的手术方法。因此,这项前瞻性试验正在继续进行。