CAJ | 학술논문

目的比较进展期胃中上部癌行腹腔镜辅助全胃切除术与开腹根治性全胃切除术时对围脾门区域淋巴结的清扫情况.方法选取2008年9月至2011年1月进展期胃中上部癌患者312例,按手术方式分为腹腔镜辅助全胃切除术(腹腔镜组)及开腹根治性全胃切除术(开腹组),每组156例,观察比较两组的围脾门区域淋巴结清扫情况.结果腹腔镜组和开腹组清扫的淋巴结数目分别为( 29.57±9.62)枚和(29.38±11.22)枚,两组差异无统计学意义(P=0.875).腹腔镜组和开腹组围脾门区域(第10、11d组)清扫淋巴结数目分别为(2.01±1.34)枚和(1.33±1.11)枚,两组差异有统计学意义(P=0.000).腹腔镜组和开腹组围腹腔干区域(第7、8、9、11p及12a2组)清扫淋巴结数目分别为(7.90±3.41)枚和(7.22±2.65)枚,差异无统计学意义(p=0.050).两组患者在贲门区域(第1、2组)、幽门区域(第5、6组)和大小网膜区域(第3、4组)清扫淋巴结数目的差异均无统计学意义(P=0.605,P=0.248,P=0.262).结论在进展期胃癌中,腹腔镜下行根治性全胃切除术在围脾门区域淋巴结清扫方面较开腹手术更具优势.
목적 비교진전기위중상부암행복강경보조전위절제술여개복근치성전위절제술시대위비문구역림파결적청소정황.방법 선취2008년9월지2011년1월진전기위중상부암환자312례,안수술방식분위복강경보조전위절제술(복강경조)급개복근치성전위절제술(개복조),매조156례,관찰비교량조적위비문구역림파결청소정황.결과 복강경조화개복조청소적림파결수목분별위( 29.57±9.62)매화(29.38±11.22)매,량조차이무통계학의의(P=0.875).복강경조화개복조위비문구역(제10、11d조)청소림파결수목분별위(2.01±1.34)매화(1.33±1.11)매,량조차이유통계학의의(P=0.000).복강경조화개복조위복강간구역(제7、8、9、11p급12a2조)청소림파결수목분별위(7.90±3.41)매화(7.22±2.65)매,차이무통계학의의(p=0.050).량조환자재분문구역(제1、2조)、유문구역(제5、6조)화대소망막구역(제3、4조)청소림파결수목적차이균무통계학의의(P=0.605,P=0.248,P=0.262).결론 재진전기위암중,복강경하행근치성전위절제술재위비문구역림파결청소방면교개복수술경구우세.
Objective To compare the number of harvested perisplenic hilar lymph nodes by laparoscopy-assisted total gastrectomy (LATG) and conventional open total gastrectomy (OTG) for advanced upper and middle gastric cancer.Methods Three hundred twelve patients with advanced gastric cancer treated in a single institution between Sept 2008 and Jan 2011 were included in this study.They were derided into two groups:the LATG group and OTG (D2) group.All the surgical operations were performed by one surgeon or under his supervision.The lymph node clearance outcomes of the patients treated by those two surgical procedures were analyzed.Results The harvested lymph node numbers of the two groups were (29.57 ± 9.62 ) and (29.38 ± 11.22) respectively,statistically with no significant difference ( P =0.875 ).The numbers of lymph node dissected around the splenic area in the LATG group and OTG group ( Section 10,11 group) were (2.01 ± 1.34) and (1.33 ± 1.11 ),respectively,indicating a significant difference (P =0.000).The numbers of lymph nodes dissected around the celiac region (Section 7,8,9,11p and 12a2 group) were (7.90 ± 3.41 ) and (7.22 ± 2.65 ),respectively,with a non-significant difference (P =0.050).There were also no significant diffrences while comparing with the numbers of lymph nodes dissected in the cardiac area (group 1,2),pyloric region (5,6 group) and the greater and lesser omentum area ( group 3 and 4) between the two groups ( P =0.605,P =0.248,P =0.262).Conclusion Shortterm results of this study indicate that laparoscopy-assisted total gastrectomy (D2) is better than conventional open surgery in perisplenic hilar lymph node dissection.