Masuzawa Toru, Sugimura Keijiro, Katsuyama Shinsuke, Ikeshima Ryo, Shinke Go, Kawai Kenji, Hiraki Masayuki, Katsura Yoshiteru, Ohmura Yoshiaki, Hata Taishi, Takeda Yutaka, Murata Kohei
Dept. of Gastroenterological Surgery, Kansai Rosai Hospital.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1908-1910.
Total gastrectomy for remnant gastric cancer is one of the most difficult procedures in gastric cancer surgery. In our hospital, we have performed laparotomy so far, but in recent years we have shifted to laparoscopic surgery. We verified the safety and usefulness of laparoscopic surgery from the surgical cases in our hospital. We compared the surgical outcomes of 26 patients who underwent laparotomy or laparoscopic total gastrectomy for remnant gastric cancer after 2010. 19 patients had undergone gastrectomy for gastric cancer, and 7 patients had done for benign diseases. In the gastrectomy of remnant gastric cancer, laparotomy was performed in 19 patients and laparoscopic surgery was performed in 7 patients. The laparoscopic group had a long operation time(274 vs 402 min), less bleeding(434 vs 124 mL), more lymph node dissection(11 vs 20 lymph nodes). The rate of postoperative complications(Clavien-Dindo classification more than Grade 2)was low(42.1 vs 28.6%), and the length of hospital stay after surgery was short(14 vs 10 days). No postoperative death was observed in all patients. Conclusion: It was considered that laparoscopic surgery can be safety performed and is a useful surgical procedure for remnant gastric cancer.
残胃癌全胃切除术是胃癌手术中最具难度的手术之一。在我院，到目前为止我们一直采用开腹手术，但近年来已转向腹腔镜手术。我们从我院的手术病例中验证了腹腔镜手术的安全性和实用性。我们比较了2010年后接受开腹或腹腔镜残胃癌全胃切除术的26例患者的手术结果。19例患者因胃癌接受了胃切除术，7例患者因良性疾病接受了胃切除术。在残胃癌胃切除术中，19例患者采用开腹手术，7例患者采用腹腔镜手术。腹腔镜组手术时间长（274对402分钟），出血少（434对124毫升），淋巴结清扫多（11对20个淋巴结）。术后并发症发生率（Clavien-Dindo分级超过2级）较低（42.1对28.6%），术后住院时间短（14对10天）。所有患者均未观察到术后死亡。结论：认为腹腔镜手术可安全实施，是治疗残胃癌的一种有用的手术方法。
