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首页> 外文期刊>Surgical Endoscopy >Clinical significance of medial approach for suprapancreatic lymph node dissection during laparoscopic gastric cancer surgery
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Clinical significance of medial approach for suprapancreatic lymph node dissection during laparoscopic gastric cancer surgery

机译：腹腔镜胃癌手术中胰腺上淋巴结清扫术的临床意义

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Objective: Suprapancreatic lymph node dissection is critical for gastric cancer surgery. Beginning in 2010, a medial approach was adopted for suprapancreatic lymph node dissection during laparoscopic gastrectomy for distal gastric cancer in our institution. The aim of this study was to compare surgical outcomes of the medial approach and conventional approach in laparoscopic gastric surgery. Methods: Between January 2007 and December 2012, a total of 100 patients with clinical T1 or T2 tumors underwent laparoscopic distal gastrectomy involving suprapancreatic lymph node dissection by the medial approach (n = 44) and conventional approach (n = 56) with curative intent. The comparison was based on clinicopathological characteristics and surgical outcome. Results: The laparoscopic procedure was not converted to laparotomy in any patient. The patients' demographics and tumor characteristics did not show any statistically significant difference, except for tumor location. In the conventional approach group, the tumors were at a higher position (p = 0.037) and more frequently received Roux-en-Y reconstruction (p < 0.001). Intracorporeal anastomosis was significantly more common in the medial approach group (p < 0.001). Compared with the conventional approach, the medial approach was associated with significantly less operative blood loss (p < 0.001), more retrieved suprapancreatic lymph nodes (p = 0.019), and a shorter hospital stay (p = 0.018). The rates of complications were comparable between the two groups. Conclusion: This study suggests that the medial approach to suprapancreatic lymph node dissection seems to be convenient and useful in laparoscopic gastric cancer surgery.
机译：目的：胰腺上淋巴结清扫术对胃癌手术至关重要。从2010年开始，在本院腹腔镜胃切除术中，对于远端胃癌，采用了内侧方法进行上腹胰腺淋巴结清扫术。这项研究的目的是比较腹腔镜胃手术中内侧入路和常规入路的手术效果。方法：自2007年1月至2012年12月，共有100例临床T1或T2肿瘤患者接受腹腔镜远端胃切除术，其中有方法行内侧media门淋巴结清扫术（n = 44）和常规方法（n = 56），且均具有治愈目的。比较是基于临床病理特征和手术结果。结果：在任何患者中，腹腔镜手术均未转换为剖腹手术。除肿瘤位置外，患者的人口统计学和肿瘤特征均无统计学差异。在常规治疗组中，肿瘤位于较高的位置（p = 0.037），并且更频繁地接受Roux-en-Y重建（p <0.001）。体内吻合术在内侧入路组中更为普遍（p <0.001）。与传统方法相比，内侧方法与手术失血量显着减少（p <0.001），胰腺上淋巴结恢复多（p = 0.019）和住院时间更短（p = 0.018）。两组的并发症发生率相当。结论：这项研究表明，腹腔镜上淋巴结清扫术在腹腔镜胃癌手术中似乎是方便和有用的。

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