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首页> 外文期刊>Surgical Endoscopy >Laparoscopy-assisted pancreas- and spleen-preserving total gastrectomy for gastric cancer as compared with open total gastrectomy.
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Laparoscopy-assisted pancreas- and spleen-preserving total gastrectomy for gastric cancer as compared with open total gastrectomy.

机译：与开放式全胃切除术相比，腹腔镜辅助的保留胰腺和脾脏的全胃切除术治疗胃癌。

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BACKGROUND: Laparoscopy-assisted total gastrectomy (LATG) is not widely used for the treatment of gastric cancer located in the upper or middle third of the stomach. To assess the safety and usefulness of LATG, we compared the outcomes of LATG with those of open total gastrectomy (OTG). METHODS: From July 2004 to July 2007, we performed pancreas- and spleen-preserving total gastrectomy with D1 + beta or D2 lymph-node dissection and Roux-en-Y reconstruction in 74 patients with cancer located in the upper or middle third of the stomach. Of these patients, 30 underwent LATG (LATG group) and 44 underwent OTG (OTG group). Short-term outcomes were compared between the groups. RESULTS: Operation time was significantly longer in the LATG group than in the OTG group (313 min vs. 218 min, p < 0.001). Blood loss (134 g vs. 407 g, p < 0.001) and the rate of the use of analgesics (6.8 times vs. 11.8 times, p < 0.05) were significantly lower, and postoperative hospital stay was significantly shorter in the LATG group than in the OTG group (13.5 days vs. 18.2 days, p < 0.05). The LATG group had better hematologic and serum chemical profiles, including white-cell counts, C-reactive protein levels, total protein levels, and albumin levels, as well as lower rate of postoperative body-weight loss. The number of dissected lymph nodes (43.2 vs. 51.2, p = 0.098) and the rate of postoperative complications (20.0% vs. 27.3%, p = 0.287) were similar in the groups. However, major complications such as anastomotic leakage, abdominal abscess, and pancreatic leakage occurred in six patients (13.6%) in the OTG group, but in none of the patients in the LATG group. CONCLUSIONS: LATG is associated with less severe complications and better postoperative quality of life than OTG. We believe that LATG is a safe, useful, and less invasive alternative for the treatment of gastric cancer located in the upper or middle third of the stomach.
机译：背景：腹腔镜辅助全胃切除术（LATG）尚未广泛用于治疗位于胃上部或中部三分之一的胃癌。为了评估LATG的安全性和有效性，我们比较了LATG与开放式全胃切除术（OTG）的结果。方法：从2004年7月至2007年7月，我们对74例位于上，中三分之一的癌症患者进行了D1 +β或D2淋巴结清扫术并保留了胰腺和脾脏的全胃切除术，并进行了D1 +β或D2淋巴结清扫术。胃。在这些患者中，30例接受了LATG（LATG组），44例接受了OTG（OTG组）。比较两组之间的短期结果。结果：LATG组的手术时间明显长于OTG组（313分钟vs. 218分钟，p <0.001）。 LATG组的失血量（134 g vs. 407 g，p <0.001）和止痛剂的使用率（6.8倍vs. 11.8倍，p <0.05）显着降低，并且LATG组的术后住院时间明显短于LATG组OTG组（13.5天vs 18.2天，p <0.05）。 LATG组具有更好的血液学和血清化学特征，包括白细胞计数，C反应蛋白水平，总蛋白水平和白蛋白水平，以及术后体重减轻率较低。各组的淋巴结清扫数目（43.2 vs. 51.2，p = 0.098）和术后并发症发生率（20.0％vs. 27.3％，p = 0.287）相似。然而，OTG组中有6例（13.6％）患者发生了主要并发症，如吻合口漏，腹腔脓肿和胰漏，而LATG组中没有患者。结论：与OTG相比，LATG并发症少，术后生活质量更好。我们认为，LATG是治疗位于胃上部或中部三分之一的胃癌的安全，有用且侵入性较小的替代方法。

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