Kim Sang Hyun, Chung Yoona, Kim Yong Ho, Choi Sung Il
Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
Department of Surgery, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
J Gastric Cancer. 2019 Mar;19(1):83-91. doi: 10.5230/jgc.2019.19.e4. Epub 2019 Feb 15.
This study aimed to compare the oncologic and short-term outcomes of laparoscopic distal gastrectomy (LDG) and open distal gastrectomy (ODG) for advanced gastric cancer (AGC).
From July 2006 to November 2016, 384 patients underwent distal gastrectomy for AGC. Data on short- and long-term outcomes were prospectively collected and reviewed. Propensity score matching was applied at a ratio of 1:1 to compare the LDG and ODG groups.
The operative times were longer for the LDG group than for the ODG group. However, the time to resumption of diet and the length of hospital stay were shorter in the LDG group than in the ODG group (4.7 vs. 5.6 days, P=0.049 and 9.6 vs. 11.5 days, P=0.035, respectively). The extent of lymph node dissection in the LDG group was more limited than in the ODG group (P=0.002), although there was no difference in the number of retrieved lymph nodes between the 2 groups. The 3-year overall survival rates were 98% and 86.9% (P=0.018), and the 3-year recurrence-free survival rates were 86.3% and 75.3% (P=0.259), respectively, in the LDG and ODG groups.
LDG is safe and feasible for AGC, with earlier recovery after surgery and long-term oncologic outcomes comparable to those of ODG.
本研究旨在比较腹腔镜远端胃癌切除术（LDG）与开腹远端胃癌切除术（ODG）治疗进展期胃癌（AGC）的肿瘤学及短期疗效。
2006年7月至2016年11月，384例患者接受了AGC远端胃切除术。前瞻性收集并回顾了短期和长期疗效数据。采用1:1的倾向评分匹配法比较LDG组和ODG组。
LDG组的手术时间比ODG组长。然而，LDG组的饮食恢复时间和住院时间比ODG组短（分别为4.7天对5.6天，P = 0.049；9.6天对11.5天，P = 0.035）。LDG组的淋巴结清扫范围比ODG组更有限（P = 0.002），尽管两组之间的淋巴结回收数量没有差异。LDG组和ODG组的3年总生存率分别为98%和86.9%（P = 0.018），3年无复发生存率分别为86.3%和75.3%（P = 0.259）。
LDG治疗AGC安全可行，术后恢复较早，长期肿瘤学疗效与ODG相当。
