Long-term outcomes and quality of life of laparoscopic-assisted pylorus-preserving gastrectomy compared to laparoscopic-assisted distal gastrectomy with billroth I anastomosis for early gastric cancer(pT1N0M0): A Randomized Controlled Trial

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-04-14 DOI:10.1016/j.amjsurg.2025.116349

Xiang Xia , Puhua Zhang , Fengrong Yu, Gang Zhao, Enhao Zhao, Zizhen Zhang, Chunchao Zhu

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引用次数: 0

Abstract

Objective

Clarify the long-term outcomes of laparoscopic-assisted pylorus-preserving gastrectomy (LAPPG) compared to conventional laparoscopic-assisted distal gastrectomy with billroth I anastomosis (LADGBI) for early gastric cancer(pT1N0M0).

Methods

Patients with cT1N0M0 cancer located in the middle third of the stomach and not suitable for endoscopic submucosal dissection were randomized to undergo LAPPG or LADGBI.

Results

Between August 2017 and October 2019, a total 88 patients (pT1N0M0) were analyzed. The 5-year overall survival rate and disease-free survival rate were 95.5 % and 93.2 % for LAPPG and 93.2 % (P = 0.46) and 91.0 % (P = 0.64) for LADGBI. During postoperative 5-year follow up, LAPPG tended to present better functions and less symptoms scales than LADGBI accompanied by effective gallbladder emptying and pylorus function preserving.

Conclusion

Surgical and oncological outcomes was comparable in pT1N0M0 patients undergoing LAPPG and LADGBI. LAPPG had advantages in long-term QOL over LADGBI in terms of C30 and STO22 questionnaire.

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早期胃癌（pT1N0M0），腹腔镜辅助保幽门胃切除术与腹腔镜辅助远端胃切除术加billroth I吻合术的远期疗效和生活质量比较：一项随机对照试验

目的探讨腹腔镜下保幽门胃切除术（LAPPG）与传统腹腔镜下远端胃切除术+ 1号吻合术（LADGBI）治疗早期胃癌（pT1N0M0）的远期疗效。方法将位于胃中三分之一且不适合内镜下粘膜剥离的cT1N0M0癌患者随机分为LAPPG和LADGBI两组。结果2017年8月至2019年10月，共分析了88例患者（pT1N0M0）。LAPPG的5年总生存率和无病生存率分别为95.5%和93.2%，LADGBI的5年总生存率分别为93.2% （P = 0.46）和91.0% （P = 0.64）。术后5年随访，LAPPG比LADGBI功能更好，症状量表更少，胆囊排空有效，保留幽门功能。结论pT1N0M0患者行LAPPG和LADGBI的手术和肿瘤预后相当。在C30和STO22问卷上，LAPPG在长期生活质量上优于LADGBI。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.