Short-term Outcomes of Pylorus-Preserving Gastrectomy for Early Gastric Cancer: Comparison Between Extracorporeal and Intracorporeal Gastrogastrostomy

IF 3.2 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Khalid Alzahrani, Ji-Hyeon Park, H. Lee, S. Park, Jong-Ho Choi, Chaojie Wang, Fadhel Alzahrani, Y. Suh, S. Kong, D. Park, Han-Kwang Yang
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引用次数: 2

Abstract

Purpose This study aimed to compare the surgical and oncological outcomes between totally laparoscopic pylorus-preserving gastrectomy (TLPPG) with intracorporeal anastomosis and laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG) with extracorporeal anastomosis. Materials and Methods A retrospective analysis was performed in 258 patients with cT1N0 gastric cancer who underwent laparoscopic pylorus-preserving gastrectomy using two different anastomosis methods: TLPPG with intracorporeal anastomosis (n=88) and LAPPG with extracorporeal anastomosis (n=170). The following variables were compared between the two groups to assess the postoperative surgical and oncological outcomes: proximal and distal margins, number of resected lymph nodes (LNs) in total and in LN station 6, operation time, postoperative hospital stay, and postoperative morbidity including delayed gastric emptying (DGE). Results The average length of the proximal margin was similar between the TLPPG and LAPPG groups (2.35 vs. 2.73 cm, P=0.070). Although the distal margin was significantly shorter in the TLPPG group than in the LAPPG group (3.15 vs. 4.08 cm, P=0.001), no proximal or distal resection margin-positive cases were reported in either group. The average number of resected LN was similar in both groups (36.0 vs. 33.98, P=0.229; LN station 6, 5.72 vs. 5.33, P=0.399). The operation time was shorter in the TLPPG group than in the LAPPG (200.17 vs. 220.80 minutes, P=0.001). No significant differences were observed between the two groups in terms of postoperative hospital stay (9.38 vs. 10.10 days, P=0.426) and surgical complication rate (19.3% vs. 22.9%), including DGE (8.0% vs. 11.8%, P=0.343). Conclusions The oncological safety and postoperative complications of TLPPG with intracorporeal anastomosis are similar to those of LAPPG with extracorporeal anastomosis.
保幽门胃切除术治疗早期胃癌的短期疗效:体外与体内胃造口术的比较
目的比较全腹腔镜保幽门胃切除术(TLPPG)与腹腔镜辅助保幽门胃切除术(LAPPG)联合体外吻合的手术及肿瘤预后。材料与方法回顾性分析258例cT1N0型胃癌行腹腔镜保幽门胃切除术的患者,采用TLPPG +体内吻合(n=88)和LAPPG +体外吻合(n=170)两种不同的吻合方式。比较两组之间的以下变量以评估术后手术和肿瘤预后:近端和远端边缘、总淋巴结和淋巴结6站切除淋巴结(LNs)数量、手术时间、术后住院时间和术后发病率,包括胃排空延迟(DGE)。结果TLPPG组和LAPPG组近端切缘平均长度相近(2.35 vs. 2.73 cm, P=0.070)。虽然TLPPG组远端切缘明显短于LAPPG组(3.15 cm vs 4.08 cm, P=0.001),但两组均未报告近端或远端切缘阳性病例。两组平均LN切除数相似(36.0 vs. 33.98, P=0.229;LN站6 (5.72 vs. 5.33, P=0.399)。TLPPG组手术时间短于LAPPG组(200.17 vs. 220.80 min, P=0.001)。两组患者术后住院时间(9.38天vs. 10.10天,P=0.426)、手术并发症发生率(19.3% vs. 22.9%),其中DGE发生率(8.0% vs. 11.8%, P=0.343)差异无统计学意义。结论TLPPG联合体外吻合与TLPPG联合体外吻合的肿瘤安全性及术后并发症相似。
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来源期刊
Journal of Gastric Cancer
Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
4.30
自引率
12.00%
发文量
36
期刊介绍: The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.
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