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随机对照试验比较腹腔镜和开腹保留脾脏贲门胃周淋巴结清扫术治疗进展期近端胃癌的短期疗效:中期报告。

Randomized controlled trial comparing short-term outcomes of laparoscopic and open spleen-preserving splenic hilar lymphadenectomy for advanced proximal gastric cancer: An interim report.

机构信息

Department of General Surgery, Chinese PLA General Hospital, China.

Department of Endoscopic Surgery, Chinese PLA 451st Hospital, China.

出版信息

J Surg Oncol. 2018 Dec;118(8):1264-1270. doi: 10.1002/jso.25262. Epub 2018 Oct 31.

DOI:10.1002/jso.25262
PMID:30380145
Abstract

BACKGROUND AND OBJECTIVES

We compared the clinical outcomes of laparoscopic and open spleen-preserving splenic hilar lymphadenectomy (LSPL and OSPL) for gastric cancer.

METHODS

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).

RESULTS

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).

CONCLUSION

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.

摘要

背景与目的

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。

方法

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)。

结果

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)。

结论

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。

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