Department for Abdominal and General Surgery, University Clinical Centre Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia.
Langenbecks Arch Surg. 2021 Dec;406(8):2699-2708. doi: 10.1007/s00423-021-02283-w. Epub 2021 Jul 31.
We compared the initial experience of totally laparoscopic gastric cancer surgery with Eastern principles with the results of propensity score-matched counterparts operated with open surgery.
From 1163 patients stored in our database, 62 PSM patients were selected for this study. The quality control was assured with video documentation and standardisation of the procedures.
According to the distribution of age, comorbidities, and general health, patients in the LG and OG were well-balanced. Most of the patients in both groups had advanced gastric cancer (69.3%). In the OG, 67.8% of patients received a total gastrectomy, as well as 54.8% of patients in the LG. There was no significant difference in the postoperative mortality between groups. The recovery of bowel function was significantly faster, and postoperative pain was significantly decreased in the LG. Compared to the OG, the inflammatory response was significantly smaller in the LG. There was no significant difference in the overall survival between LG and OG patients.
We have shown that laparoscopic gastrectomy with Eastern principles can be safely introduced in a high-volume Western centre with sufficient laparoscopic training. We have also shown that laparoscopy offers a significant faster bowel function recovery, less postoperative pain, and a smaller inflammatory response.
我们比较了完全腹腔镜胃癌手术与东方原则的初步经验与开放性手术的倾向评分匹配对照的结果。
从我们的数据库中存储的 1163 名患者中，选择了 62 名 PSM 患者进行这项研究。通过视频记录和程序标准化来保证质量控制。
根据年龄、合并症和总体健康状况的分布，LG 和 OG 组的患者平衡良好。两组大多数患者均患有进展期胃癌（69.3%）。OG 组中有 67.8%的患者接受全胃切除术，LG 组中有 54.8%的患者接受全胃切除术。两组间术后死亡率无显著差异。LG 组患者的肠道功能恢复明显更快，术后疼痛明显减轻。与 OG 组相比，LG 组的炎症反应明显较小。LG 和 OG 患者的总生存率无显著差异。
我们已经表明，具有东方原则的腹腔镜胃癌手术可以在具有充足腹腔镜培训的大容量西方中心安全地引入。我们还表明，腹腔镜手术提供了更快的肠道功能恢复、更少的术后疼痛和更小的炎症反应。
