Ge Rui, Liu Kai, Zhang Weihan, Yang Kun, Chen Xiaolong, Zhao Linyong, Zhou Zongguang, Hu Jiankun
Department of Gastrointestinal Surgery and Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China.
Department of Gastrointestinal Surgery and Laboratory of Digestive Surgery, State Key Laboratory of Biotherapy, West China Hospital, Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, China.
J Oncol. 2022 May 31;2022:9511066. doi: 10.1155/2022/9511066. eCollection 2022.
Neoadjuvant chemotherapy is incrementally applied to remedy locally advanced gastric cancer. However, NACT also enhances the difficulty of laparoscopic lymph node dissection. The objective of our study was to evaluate the safety and feasibility of laparoscopic gastrectomy for locally advanced gastric cancer after neoadjuvant chemotherapy.
From July 2017 to December 2019, 153 patients who received neoadjuvant chemotherapy and underwent the subsequent surgical procedure were retrospectively enrolled and analyzed in the Gastrointestinal Surgery Department of West China Hospital. According to surgical methods, all the patients were sectionalized into two groups: laparoscopic assistant gastrectomy (LAG, 77 patients) and traditional open gastrectomy (OG, 76 patients). The demographic parameters, preoperative, surgical, pathological, and neoadjuvant chemotherapy features were compared between the two groups.
A total of 153 patients accepted neoadjuvant chemotherapy and surgical resection in our study. There was no statistically significant difference in demographic parameters and preoperative and neoadjuvant chemotherapy characteristics between the two groups. The LAG group illustrated less intraoperative blood loss (91.1 ± 53.1 ml vs. 125.7 ± 116.9 ml, =0.010) and shorter postoperative hospital stays (7.9 ± 2.1 days vs. 125.7 ± 116.9 days, =0.009), when compared to the OG group. Moreover, there was no disparity with respect to operative duration, number of harvested lymph nodes, and postoperative complication rates between the two groups. When considering the Clavien-Dindo classification, no statistically significant difference was indicated in all stratifications with regard to postoperative complications.
Laparoscopic gastrectomy for locally advanced gastric cancer after neoadjuvant chemotherapy is safe and feasible without increasing postoperative adverse events.
新辅助化疗逐渐应用于治疗局部进展期胃癌。然而，新辅助化疗也增加了腹腔镜淋巴结清扫的难度。本研究的目的是评估新辅助化疗后腹腔镜胃癌切除术治疗局部进展期胃癌的安全性和可行性。
回顾性纳入2017年7月至2019年12月在四川大学华西医院胃肠外科接受新辅助化疗并随后接受手术治疗的153例患者进行分析。根据手术方式，将所有患者分为两组：腹腔镜辅助胃癌切除术（LAG，77例）和传统开放胃癌切除术（OG，76例）。比较两组患者的人口统计学参数、术前、手术、病理和新辅助化疗特征。
本研究共有153例患者接受了新辅助化疗和手术切除。两组患者的人口统计学参数、术前和新辅助化疗特征无统计学差异。与OG组相比，LAG组术中出血量更少（91.1±53.1ml对125.7±116.9ml，P=0.010），术后住院时间更短（7.9±2.1天对125.7±116.9天，P=0.009）。此外，两组患者的手术时间、清扫淋巴结数目和术后并发症发生率无差异。根据Clavien-Dindo分类，两组术后并发症在所有分层中均无统计学差异。
新辅助化疗后腹腔镜胃癌切除术治疗局部进展期胃癌是安全可行的，且不增加术后不良事件。
Zotero 插件