Department of Digestive Surgery, Nihon University School of Medicine, Tokyo.
Department of Surgery, Asahikawa Cure Medics, Asahikawa-City, Hokkaido, Japan.
Surg Laparosc Endosc Percutan Tech. 2020 Jun;30(3):249-256. doi: 10.1097/SLE.0000000000000768.
Hand-assisted laparoscopic surgery is considered to provide the benefits of laparoscopic surgery in various diseases. However, limited information is available regarding the feasibility of hand-assisted laparoscopic distal gastrectomy (HALDG)-a subset of hand-assisted laparoscopic surgery-as a gastric cancer treatment. This study aimed to evaluate the usefulness of HALDG compared with laparoscopy-assisted distal gastrectomy (LADG). Consecutive patients who underwent HALDG (n=58) or LADG (n=90) for stage I gastric cancer between 2005 and 2016 were eligible. Operative time was significantly shorter and blood loss was significantly higher in HALDG than in LADG (P<0.001, both). Postoperative aminotransferase levels were significantly lower in HALDG than in LADG (P<0.001). There was no significant difference in perioperative complications, a number of analgesics, postoperative C-reactive protein levels, and 3-year relapse-free and overall survival rates between the groups. This study suggests that HALDG is a safe and feasible approach and could become an effective option for stage I gastric cancer treatment.
手助腹腔镜手术被认为在各种疾病中具有腹腔镜手术的优势。然而，关于手助腹腔镜远端胃切除术（HALDG）——手助腹腔镜手术的一个亚类——作为胃癌治疗方法的可行性的信息有限。本研究旨在评估与腹腔镜辅助远端胃切除术（LADG）相比，HALDG 的有用性。2005 年至 2016 年间，连续接受 HALDG（n=58）或 LADG（n=90）治疗 I 期胃癌的患者符合条件。HALDG 的手术时间明显短于 LADG（P<0.001），出血量明显多于 LADG（P<0.001）。HALDG 的术后转氨酶水平明显低于 LADG（P<0.001）。两组患者在围手术期并发症、镇痛药数量、术后 C 反应蛋白水平以及 3 年无复发生存率和总生存率方面无显著差异。本研究表明，HALDG 是一种安全可行的方法，可能成为 I 期胃癌治疗的有效选择。
