Department of Gastrointestinal Surgery, West District of the First Affiliated Hospital of University of Science and Technology of China, Hefei, China; Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of General Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China.
Fujian Medical University, Fuzhou, China.
Asian J Surg. 2020 Mar;43(3):488-496. doi: 10.1016/j.asjsur.2019.07.017. Epub 2019 Aug 9.
Gastric neuroendocrine carcinomas (G-NECs) are rare. This study aimed to explore the feasibility and clinical efficacy of laparoscopic surgery in patients with advanced G-NECs.
The clinicopathological data of 175 G-NECs patients who underwent radical gastrectomy in a high-volume centre were collected. One hundred fifty-one cases with advanced G-NECs (laparoscopic gastrectomy [LG] = 30, open gastrectomy [OG] = 121) were finally selected for comparison of the short-term outcomes and oncologic efficacy.
In the postoperative recovery, when comparing the OG group, the time to ambulation (3.2 d vs. 2.6 d, respectively, p = 0.049), the time to first flatus (4.1 d vs. 3.6 d, respectively, p = 0.050), the time to first soft diet (7.9 d vs. 6.7 d, respectively, p = 0.007), and the postoperative hospital stay (13.1 d vs. 11.4 d, respectively, p = 0.047) of the LG group were shorter. There was no significant difference in the postoperative complication rates between the OG and LG groups (19.8% vs. 23.3%, p = 0.671). The 3-year overall survival (OS) rate was 57.0% in the OG group and 64.4% in the LG group (p = 0.349). The 3-year disease-free survival (DFS) rate was 51.7% in the OG group and 57.4% in the LG group (p = 0.357). There was no significant difference in the 3-year OS and DFS rates between the LG and OG groups at each stage. The recurrence rate was 35.5% in the OG group and 33.0% in the LG group (p = 0.821).
The short-term outcomes and oncologic efficacy of laparoscopic gastrectomy and open gastrectomy for advanced G-NECs are comparable.
胃神经内分泌癌（G-NEC）较为罕见。本研究旨在探讨腹腔镜手术治疗晚期 G-NEC 的可行性和临床疗效。
收集一家高容量中心接受根治性胃切除术的 175 例 G-NEC 患者的临床病理资料。最终选择 151 例晚期 G-NEC 患者（腹腔镜胃切除术[LG]组=30 例，开腹胃切除术[OG]组=121 例）进行短期结局和肿瘤疗效比较。
术后恢复方面，与 OG 组相比，LG 组患者下床活动时间（分别为 2.6 d 和 3.2 d，p=0.049）、首次排气时间（分别为 3.6 d 和 4.1 d，p=0.050）、首次软食时间（分别为 6.7 d 和 7.9 d，p=0.007）和术后住院时间（分别为 11.4 d 和 13.1 d，p=0.047）均较短。OG 组和 LG 组术后并发症发生率无显著差异（19.8% vs. 23.3%，p=0.671）。OG 组和 LG 组患者的 3 年总生存率（OS）分别为 57.0%和 64.4%（p=0.349），无显著差异。OG 组和 LG 组患者的 3 年无病生存率（DFS）分别为 51.7%和 57.4%（p=0.357），无显著差异。LG 组和 OG 组各期患者的 3 年 OS 和 DFS 率均无显著差异。OG 组和 LG 组患者的复发率分别为 35.5%和 33.0%（p=0.821）。
腹腔镜胃切除术和开腹胃切除术治疗晚期 G-NEC 的短期结局和肿瘤疗效相当。
