Early results of a modified splenic hilar lymphadenectomy in laparoscopy-assisted total gastrectomy for gastric cancer with stage cT1-2: a case-control study.
Surg Endosc
; 27(6): 1923-31, 2013 Jun.
Article
em En
| MEDLINE
| ID: mdl-23271271
ABSTRACT
BACKGROUND:
The aim of this study was to explore the feasibility and early outcomes of laparoscopy-assisted total gastrectomy with a modified splenic hilar lymphadenectomy for upper- and middle-third stage cT1-2 gastric cancer.METHODS:
A total of 97 patients diagnosed with upper- and middle-third stage cT1-T2 gastric cancer were enrolled. Patients were assigned to the laparoscopy-assisted total gastrectomy group (LATG, n = 41) or the open total gastrectomy group (OTG, n = 56). All patients underwent total gastrectomy with modified splenic hilar lymphadenectomy. The operative and postoperative measures, number of retrieved lymph nodes (LNs), and complications were compared between the two groups.RESULTS:
The mean number of dissected LNs was not significantly different between the two groups 23.1 ± 8.0 in the LATG group versus 24.2 ± 7.5 in the OTG group. Compared with the OTG group, the LATG group had less operative blood loss [104.2 ± 42.9 vs. 355.6 ± 51.3 ml (p < 0.0001)], shorter time to out-of-bed activities [14.4 ± 3.2 vs. 16.5 ± 1.2 h (p < 0.0001)], shorter time to first flatus [72.2 ± 16.2 vs. 78.4 ± 8.6 h (p = 0.017)], earlier resumption of soft diet [52.8 ± 21.6 vs. 74.2 ± 12.2 h (p < 0.0001)], and shorter postoperative hospital stay [9.7 ± 2.2 vs. 13.6 ± 3.6 days (p < 0.0001)]. However, LATG had a slightly longer operating time than OTG [235.7 ± 38.5 vs. 211.5 ± 33.2 min (p = 0.001)]. The operative complications rates for the LATG and OTG groups were not significantly different 4.9 versus 5.4 %.CONCLUSION:
For upper- and middle-third stage cT1-2 gastric cancer, a limited splenic hilar lymphadenectomy strategy seems to be safe and feasible, particularly for the number of retrieved LNs. However, this technique is not suitable for cT3 disease.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Gástricas
/
Laparoscopia
/
Gastrectomia
/
Excisão de Linfonodo
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article