CAJ | 학술논문

目的：分析比较腹腔镜下全胃切除术和开腹全胃切除术治疗胃上部癌的近远期疗效。方法回顾性分析164例胃上部癌患者，分别行腹腔镜下全胃切除术或开腹全胃切除术，比较两组患者的术后并发症、总生存期（OS）和无病生存期（DFS）以了解两组患者的远期疗效。结果两组患者一般资料的差异无统计学意义。与开腹组相比，腹腔镜组患者的术中失血少，麻醉次数少，排气时间早且住院时间短。两组的术后并发症发生率、OS和DFS无显著组间差异。多变量Cox回归分析发现，病理T、N分期是OS和DFS的独立预后影响因子。结论与开腹全胃切除术相比，腹腔镜下全胃切除术治疗胃上部癌的远期临床疗效相当。
목적：분석비교복강경하전위절제술화개복전위절제술치료위상부암적근원기료효。방법회고성분석164례위상부암환자，분별행복강경하전위절제술혹개복전위절제술，비교량조환자적술후병발증、총생존기（OS）화무병생존기（DFS）이료해량조환자적원기료효。결과량조환자일반자료적차이무통계학의의。여개복조상비，복강경조환자적술중실혈소，마취차수소，배기시간조차주원시간단。량조적술후병발증발생솔、OS화DFS무현저조간차이。다변량Cox회귀분석발현，병리T、N분기시OS화DFS적독립예후영향인자。결론여개복전위절제술상비，복강경하전위절제술치료위상부암적원기림상료효상당。
Objective This study aimed to evaluate long-term outcomes between laparoscopy-assisted and open approaches to total gastrectomy for upper gastric cancer. Methods Consecutive patients with upper gastric cancer who underwent total gas-trectomy via laparoscopy-assisted approach or open approach were reviewed. Overall survival (OS) and disease-free survival (DFS) was evaluated using the Kaplan-Meier method, univariate and multivariate analysis. We matched all 82 laparoscopic cases 1:1 with open cases according to age, sex, body mass index and clinical TNM stage. Results The two groups were similar in terms of demographics, comorbidities, BMI, clinical stage, pathological stage and lymphadenectomy. The laparoscopy-assist-ed approach was associated with a significant decrease in surgical blood loss, number of analgesic injections, time to first flatus and length of hospital stay relative to the open approach. The postoperative morbidity did not differ between the two groups. There were no significant differences between the two groups in OS and DFS. Multivariable Cox regression analysis revealed pathologic T stage and pathologic N disease to be independent predictors of OS and DFS. Conclusion The laparoscopy-assisted approach to total gastrectomy for upper gastric cancer results in comparable long-term survival compared with laparotomy.