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腹腔镜胃癌切除术:单癌症中心经验

Laparoscopic gastrectomy for gastric cancer: A single cancer center experience.

作者信息

Abouzid Amr, Setit Ahmed, Abdallah Ahmed, Abd Elghaffar Mohamed, Shetiwy Mosab, Elzahaby Islam A

机构信息

Department of Surgical Oncology, Oncology Center, Mansoura University, Mansoura, Egypt.

出版信息

Turk J Surg. 2023 Dec 29;39(4):354-364. doi: 10.47717/turkjsurg.2023.6158. eCollection 2023 Dec.

Abstract

OBJECTIVES

Laparoscopic gastrectomy (LG) was challenging to most surgeons due to the two-dimensional view, difficult manipulations of the instruments, ergonomic discomfort, and the associated muscular spasm and effort. Technological advances with improved surgical experience, have made LG a more feasible and favorable approach for gastric cancer (GC) patients.

MATERIAL AND METHODS

LG was performed in 44 patients with GC between July 2015 to June 2022, in the Department of Surgical Oncology, Oncology Center, Mansoura University, Egypt, and we assessed the surgical outcomes of this approach as an initial experience of a single cancer center.

RESULTS

Twenty-seven patients underwent laparoscopic distal gastrectomy, and seventeen underwent laparoscopic total gastrectomy. Two cases had combined resection. Operative time was 339.2 ± 76.73 min, while blood loss was 153.86 ± 57.51 mL. The patients were ambulant on postoperative day 0, oral intake was started within three days (range 1-5 days) and the hospital stay was six days (range 3-9 days).

CONCLUSION

LG for GC is a feasible approach for both early and advanced GC patients as it allows for adequate diagnosis of the peritoneal disease, meticulous dissection, and identification of the lymph nodes with minimal blood loss and decrease surgery-related problems and encourage the early patients' discharge from hospital and return to daily life activities.

摘要

目的

由于二维视野、器械操作困难、人体工程学不适以及相关的肌肉痉挛和用力问题,腹腔镜胃切除术(LG)对大多数外科医生来说具有挑战性。随着手术经验的增加和技术的进步,LG已成为胃癌(GC)患者更可行且更有利的治疗方法。

材料与方法

2015年7月至2022年6月期间,埃及曼苏拉大学肿瘤中心外科肿瘤学系对44例GC患者实施了LG,我们将这种治疗方法的手术结果作为单一癌症中心的初步经验进行评估。

结果

27例患者接受了腹腔镜远端胃切除术,17例接受了腹腔镜全胃切除术。2例患者进行了联合切除。手术时间为339.2±76.73分钟,失血量为153.86±57.51毫升。患者术后第0天即可下床活动,术后三天内(1 - 5天)开始经口进食,住院时间为6天(3 - 9天)。

结论

LG治疗GC对早期和晚期GC患者都是一种可行的方法,因为它能够充分诊断腹膜疾病,进行细致的解剖,并识别淋巴结,同时失血量最少,减少与手术相关的问题,并促使患者早日出院并恢复日常生活活动。

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本文引用的文献

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Laparoscopic Versus Open Gastrectomy for Gastric Cancer (LOGICA): A Multicenter Randomized Clinical Trial.
J Clin Oncol. 2021 Mar 20;39(9):978-989. doi: 10.1200/JCO.20.01540. Epub 2021 Jan 6.
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Laparoscopic versus open gastrectomy for serosa-invasive gastric cancer: A single-center retrospective cohort study.
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