Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.
J Egypt Natl Canc Inst. 2020 Feb 18;32(1):10. doi: 10.1186/s43046-020-00023-7.
Laparoscopic gastrectomy has been used as a superior alternative to open gastrectomy for the treatment of early gastric cancer. However, the application of laparoscopic D2 lymphadenectomy remains controversial. This study aimed to evaluate the feasibility and outcomes of laparoscopic gastrectomy with D2 lymphadenectomy for gastric cancer.
Between May 2016 and May 2018, twenty-five consecutive patients with gastric cancer underwent laparoscopic D2 gastrectomy: eighteen patients (72%) underwent distal gastrectomy, four patients (16%) underwent total gastrectomy, and three patients (12%) underwent proximal gastrectomy. The median number of lymph nodes retrieved was 18 (5-35). A positive proximal margin was detected in 2 patients (8%). The median operative time and amount of blood loss were 240 min (200-330) and 250 ml (200-450), respectively. Conversion to an open procedure was performed in seven patients (28%). The median hospital stay period was 8 days (6-30), and the median time to start oral fluids was 4 days (3-30). Postoperative complications were detected in 4 patients (16%). There were two cases of mortality (8%) in the postoperative period, and two patients required reoperation (8%).
Laparoscopic gastrectomy with D2 lymphadenectomy can be carried out safely and in accordance with oncologic principles.
腹腔镜胃切除术已被用作治疗早期胃癌的一种优于开腹胃切除术的替代方法。然而，腹腔镜 D2 淋巴结清扫术的应用仍存在争议。本研究旨在评估腹腔镜 D2 淋巴结清扫术治疗胃癌的可行性和结果。
2016 年 5 月至 2018 年 5 月，连续 25 例胃癌患者接受了腹腔镜 D2 胃切除术：18 例（72%）行远端胃切除术，4 例（16%）行全胃切除术，3 例（12%）行近端胃切除术。淋巴结检出中位数为 18 枚（5-35 枚）。2 例（8%）患者近端切缘阳性。手术时间中位数为 240 分钟（200-330 分钟），出血量中位数为 250 毫升（200-450 毫升）。7 例（28%）患者转为开腹手术。中位住院时间为 8 天（6-30 天），开始口服液体的中位时间为 4 天（3-30 天）。4 例（16%）患者发生术后并发症。术后有 2 例死亡（8%），2 例患者需要再次手术（8%）。
腹腔镜 D2 淋巴结清扫术治疗胃癌是安全的，符合肿瘤学原则。
