Wang Feng, Zhang Shengbo, Zhao Wei, Wang Deyou, Tang Sifeng, Zhang Qiwen
Department of Gastrointestinal Surgery, The People's Hospital of Jinan City, Jinan, China.
J Gastrointest Oncol. 2021 Dec;12(6):2743-2748. doi: 10.21037/jgo-21-782.
Laparoscopic distal gastrectomy (LDG) is gaining popularity because its early postoperative effect has been shown to be better than open distal gastrectomy (ODG). However, to our knowledge, there are no studies demonstrating ODG is oncologically equivalent to LDG.
This is a retrospective study based on the prospectively maintained database of the People's Hospital of Jinan City. Patients with operable, pathologically confirmed early-stage gastric cancer were included, while those with advanced disease or carcinoma were excluded. Extracted data included age, body mass index (BMI), sex, clinical TNM stage, and pathologic stage. The primary outcome was 5-year overall survival, and the secondary outcomes included cancer-specific survival, cost-effectiveness, and quality of life.
A total of 126 patients were finally enrolled and included 61 in the ODG group and 65 in the LDG group. Baseline clinical and pathological characteristics were generally balanced between the two groups. After a median follow-up of 8.31 years, the 5-year overall survival rate was estimated to be 82.8% (95% CI: 69.4-90.7%) for the ODG group and 86.7% (95% CI: 73.9-93.5%) for the LDG group and the recurrence patterns were similar between the two groups.
Our data showed that the surgical results of both approaches are satisfactory, and LDG offers a reasonable option to ODG in patients with early gastric cancer.
腹腔镜远端胃癌切除术(LDG)越来越受欢迎,因为其术后早期效果已被证明优于开放远端胃癌切除术(ODG)。然而,据我们所知,尚无研究表明ODG在肿瘤学上与LDG等效。
这是一项基于济南市人民医院前瞻性维护数据库的回顾性研究。纳入可手术、病理确诊的早期胃癌患者,排除晚期疾病或癌症患者。提取的数据包括年龄、体重指数(BMI)、性别、临床TNM分期和病理分期。主要结局是5年总生存率,次要结局包括癌症特异性生存率、成本效益和生活质量。
最终共纳入126例患者,其中ODG组61例,LDG组65例。两组的基线临床和病理特征总体平衡。中位随访8.31年后,ODG组的5年总生存率估计为82.8%(95%CI:69.4-90.7%),LDG组为86.7%(95%CI:73.9-93.5%),两组的复发模式相似。
我们的数据表明,两种手术方法的手术结果均令人满意,对于早期胃癌患者,LDG是ODG的合理选择。