期刊论文详细信息
World Journal of Surgical Oncology
Laparoscopy-assisted gastrectomy with D2 lymph node dissection for advanced gastric cancer without serosa invasion: a matched cohort study from South China
Jun Lu1  Jia-Bin Wang1  Jian-Wei Xie1  Ping Li1  Chao-Hui Zheng1  Chang-Ming Huang1  Jian-Xian Lin1 
[1] Department of Gastric Surgery, Fujian Medical University Union Hospital, No 29 Xinquan Road, Fuzhou, Fujian Province, 350001, China
关键词: Open gastrectomy;    Matched cohort study;    Laparoscopy-assisted gastrectomy;    D2 lymphadenectomy;    Advanced gastric cancer;   
Others  :  826604
DOI  :  10.1186/1477-7819-11-4
 received in 2012-08-18, accepted in 2012-12-24,  发布年份 2013
PDF
【 摘 要 】

Background

Gastric cancer is a common malignancy worldwide and a common cause of death from cancer. Despite recent advances in multimodality treatment and targeted therapy, complete resection remains the only treatment that can lead to cure. This study was devised to investigate the technical feasibility, safety and oncologic efficacy of laparoscopy-assisted gastrectomy for advanced gastric cancer without serosa invasion.

Methods

A retrospective matched cohort study was performed in south China comparing laparoscopy-assisted gastrectomy and open gastrectomy for advanced gastric cancer without serosa invasion. Eighty-three patients with advanced gastric cancer undergoing laparoscopy-assisted gastrectomy between January 2008 and December 2010 were enrolled. These patients were compared with 83 patients with advanced gastric cancer undergoing open gastrectomy during the same period.

Results

There was no significant difference in clinicopathologic characteristics between the two groups. Regarding perioperative characteristics, the operation time and time to ground activities did not differ between the two groups, whereas the blood loss, transfused patient number, time to first flatus, time to resumption of diet, and postoperative hospital stay were significantly less in laparoscopy-assisted gastrectomy than in open gastrectomy (P <0.05). There was no statistically significant difference in postoperative morbidity and mortality. No significant difference in the number of lymph nodes dissected was observed between these two groups. There was no significant difference in the cumulative survival rate between the two groups.

Conclusion

Laparoscopy-assisted gastrectomy with D2 lymphadenectomy is a safe and feasible procedure for advanced gastric cancer without serosa invasion. To be accepted as a choice treatment for advanced gastric cancer, well-designed randomized controlled trials comparing short-term and long-term outcomes between laparoscopy-assisted gastrectomy and open gastrectomy in a larger number of patients are necessary.

【 授权许可】

   
2013 Lin et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20140713101202436.pdf 1407KB PDF download
Figure 6. 15KB Image download
Figure 5. 22KB Image download
Figure 4. 21KB Image download
Figure 3. 90KB Image download
Figure 2. 86KB Image download
Figure 1. 83KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

Figure 6.

【 参考文献 】
  • [1]Parkin DM, Bray F, Ferlay J, Pisani P: Global Cancer statistics 2002. CA Cancer J Clin 2005, 55:74-108.
  • [2]Kitano S, Iso Y, Moriyama M, Sugimachi K: Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 1994, 4(2):146-148.
  • [3]Han HS, Kim YW, Yi NJ, Fleischer GD: Laparoscopy-assisted D2 subtotal gastrectomy in early gastric cancer. Surg Laparosc Endosc Percutan Tech 2003, 13(6):361-365.
  • [4]Lee JH, Han HS, Lee JH: A prospective randomized study comparing open vs laparoscopy-assisted distal gastrectomy in early gastric cancer: early results. Surg Endosc 2005, 19(2):168-173.
  • [5]Lee JH, Yom CK, Han HS: Comparison of long-term outcomes of laparoscopy-assisted and open distal gastrectomy for early gastric cancer. Surg Endosc 2009, 23(8):1759-1763.
  • [6]Uyama I, Sugioka A, Fujita J, Komori Y, Matsui H, Hasumi A: Laparoscopic total gastrectomy with distal pancreato-splenectomy and D2 lymphadenectomy for advanced gastric cancer. Gastric Cancer 1999, 2:230-234.
  • [7]Sobin LH, Gospodarowicz MK, Wittekind C: International Union Against Cancer (UICC) TNM classification of malignanttumours. 7th edition. New York: Wiley-Liss; 2010.
  • [8]Mochiki E, Kamiyama Y, Aihara R, Nakabayashi T, Asao T, Kuwano H: Laparoscopic assisted distal gastrectomy for early gastric cancer: five years' experience. Surgery 2005, 137(3):317-322.
  • [9]Yakoub D, Athanasiou T, Tekkis P, Hanna GB: Laparoscopic assisted distal gastrectomy for early gastric cancer: is it an alternative to the open approach? Surg Oncol 2009, 18(4):322-333.
  • [10]Dicken BJ, Bigam DL, Cass C, Mackey JR, Joy AA, Hamilton SM: Gastric adenocarcinoma: review and considerations for future directions. Ann Surg 2005, 241(1):27-39.
  • [11]Sasako M, Sano T, Yamamoto S, Kurokawa Y, Nashimoto A, Kurita A, Hiratsuka M, Tsujinaka T, Kinoshita T, Arai K, Yamamura Y, Okajima K, Japan Clinical Oncology Group: D2 lymphadenectomy alone or with para-aortic nodal dissection for gastric cancer. N Engl J Med 2008, 359(5):453-462.
  • [12]Songun I, Putter H, Kranenbarg EM, Sasako M, van de Velde CJ: Surgical treatment of gastric cancer: 15-year follow-up results of the randomized nationwide DUTCH D1 D2 trial. Lancet Oncol 2010, 11(5):439-449.
  • [13]Hur H, Jeon HM, Kim W: Laparoscopy-assisted distal gastrectomy with D2 lymphadenectomy for T2b advanced gastric cancers: three years’ experience. J Surg Oncol 2008, 98(7):515-519.
  • [14]Kawamura H, Homma S, Yokota R, Yokota K, Watarai H, Hagiwara M, Sato M, Noguchi K, Ueki S, Kondo Y: Inspection of safety and accuracy of D2 lymph node dissection in laparoscopy-assisted distal gastrectomy. World J Surg 2008, 32(11):2366-2370.
  • [15]Tanimura S, Higashino M, Fukunaga Y, Takemura M, Tanaka Y, Fujiwara Y, Osugi H: Laparoscopic gastrectomy for gastric cancer: experience with more than 600 cases. Surg Endosc 2008, 22(5):1161-1164.
  • [16]Bo T, Zhihong P, Peiwu Y, Feng Q, Ziqiang W, Yan S, Yongliang Z, Huaxin L: General complications following laparoscopic-assisted gastrectomy and analysis of techniques to manage them. Surg Endosc 2009, 23(8):1860-1865.
  • [17]Tekkis PP, Senagore AJ, Delaney CP, Fazio VW: Evaluation of the learning curve in laparoscopic colorectal surgery: comparison of right-sided and left-sided resections. Ann Surg 2005, 242(1):83-91.
  • [18]Tekkis PP, Fazio VW, Lavery IC, Remzi FH, Senagore AJ, Wu JS, Strong SA, Poloneicki JD, Hull TL, Church JM: Evaluation of the learning curve in ileal pouch-anal anastomosis surgery. Ann Surg 2005, 241(2):262-268.
  • [19]Shikora SA, Kim JJ, Tarnoff ME, Raskin E, Shore R: Laparoscopic Roux-en-Y gastric bypass: results and learning curve of a high-volume academic program. Arch Surg 2005, 140(4):362-367.
  • [20]Poon RT, Ng KK, Lam CM, Ai V, Yuen J, Fan ST, Wong J: Learning curve for radiofrequency ablation of liver tumors: prospective analysis of initial 100 patients in a tertiary institution. Ann Surg 2004, 239(4):441-449.
  • [21]Schlachta CM, Mamazza J, Seshadri PA, Cadeddu M, Gregoire R, Poulin EC: Defining a learning curve for laparoscopic colorectal resections. Dis Colon Rectum 2001, 44(2):217-222.
  • [22]Kunisaki C, Makino H, Yamamoto N, Sato T, Oshima T, Nagano Y, Fujii S, Akiyama H, Otsuka Y, Ono HA, Kosaka T, Takagawa R, Shimada H: Learning curve for laparoscopy-assisted distal gastrectomy with regional lymph node dissection for early gastric cancer. Surg Laparosc Endosc Percutan Tech 2008, 18(3):236-241.
  • [23]Lee SI, Choi YS, Park DJ, Kim HH, Yang HK, Kim MC: Comparative study of laparoscopy-assisted distal gastrectomy and open distal gastrectomy. J Am Coll Surg 2006, 202(6):874-880.
  • [24]Hwang SI, Kim HO, Yoo CH, Shin JH, Son BH: Laparoscopy-assisted distal gastrectomy versus open distal gastrectomy for advanced gastric cancer. Surg Endosc 2009, 23(6):1252-1258.
  • [25]Scatizzi M, Kröning KC, Lenzi E, Moraldi L, Cantafio S, Feroci F: Laparoscopic versus open distal gastrectomy for locally advanced gastric cancer: a case–control study. Updates Surg 2011, 63(1):17-23.
  • [26]Kodera Y, Fujiwara M, Ohashi N, Nakayama G, Koike M, Morita S, Nakao A: Laparoscopic surgery for gastric cancer: a collective review with meta-analysis of randomized trials. J Am Coll Surg 2010, 211(5):677-686.
  • [27]Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N: A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg 2007, 245(1):68-72.
  • [28]Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, Ryu SW, Lee HJ, Song KY: Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report—a phase III multicenter, prospective, randomized trial (KLASS trial). Ann Surg 2010, 251(3):417-420.
  • [29]Miura S, Kodera Y, Fujiwara M, Ito S, Mochizuki Y, Yamamura Y, Hibi K, Ito K, Akiyama S, Nakao A: Laparoscopy-assisted distal gastrectomy with systemic lymph node dissection: a critical reappraisal from the viewpoint of lymph node retrieval. J Am CollSurg 2004, 198(6):933-938.
  • [30]Huscher C, Mingoli A, Sgarzini G, Sansonetti A, Piro F, Ponzano C, Brachini G: Value of extended lymphadenectomy in laparoscopic subtotal gastrectomy for advanced gastric cancer. J Am Coll Surg 2005, 200(2):314.
  • [31]Song KY, Kim SN, Park CH: Laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer: technical and oncologic aspects. SurgEndosc 2008, 22(3):655-659.
  • [32]Shuang J, Qi S, Zheng J, Zhao Q, Li J, Kang Z, Hua J, Du J, Shuang J, Qi S, Zheng J, Zhao Q, Li J, Kang Z, Hua J, Du J: A case–control study of laparoscopy-assisted and open distal gastrectomy for advanced gastric cancer. J Gastrointest Surg 2011, 15(1):57-62.
  • [33]Ibanez Aguirre FJ, Azagra JS, ErroAzcárate ML, Goergen M, Rico Selas P, Moreno Elola-Olaso A, Clemares de Lama M, de Simone P, EcheniqueElizondo MM: Laparoscopic gastrectomy for gastric adenocarcinoma. Long-term results. Rev Esp Enferm Dig 2006, 98(7):491-500.
  • [34]Azagra JS, Ibanez Aguirre JF, Goergen M, Ceuterick M, Bordas-Rivas JM, Almendral-López ML, Moreno-Elola A, Takieddine M, Guérin E: Long-term results of laparoscopic extended surgery in advanced gastric cancer: a series of 101 patients. Hepatogastroenterology 2006, 53(68):304-308.
  文献评价指标  
  下载次数:11次 浏览次数:3次