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手助腹腔镜与腹腔镜辅助远端胃癌根治术近期疗效比较。

Comparison of Short-Term Outcomes Between Hand-assisted Laparoscopic Distal Gastrectomy and Laparoscopy-assisted Distal Gastrectomy in Gastric Cancer.

机构信息

Department of Digestive Surgery, Nihon University School of Medicine, Tokyo.

Department of Surgery, Asahikawa Cure Medics, Asahikawa-City, Hokkaido, Japan.

出版信息

Surg Laparosc Endosc Percutan Tech. 2020 Jun;30(3):249-256. doi: 10.1097/SLE.0000000000000768.

Abstract

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.

摘要

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。

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