超重和肥胖胃癌患者单切口腹腔镜远端胃切除术的安全性和可行性:倾向评分匹配分析。

IF 6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Gastric Cancer Pub Date : 2024-09-01 Epub Date: 2024-07-18 DOI:10.1007/s10120-024-01530-5
Eunju Lee, Yun-Suhk Suh, Mira Yoo, Duyeong Hwang, So Hyun Kang, Sangjun Lee, Young Suk Park, Sang-Hoon Ahn, Seong-Ho Kong, Do Joong Park, Hyuk-Joon Lee, Hyung-Ho Kim, Han-Kwang Yang
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引用次数: 0

摘要

背景:对超重和肥胖胃癌患者进行单切口腹腔镜胃切除术的技术挑战和安全问题仍不清楚。本研究旨在评估单切口腹腔镜远端胃切除术(SIDG)与多孔腹腔镜远端胃切除术(MLDG)在超重和肥胖胃癌患者中的安全性和可行性:本研究对超重和肥胖(体重指数≥ 25 kg/m2)且病理分期为 T1 的原发性胃腺癌患者接受 SIDG 或 MLDG 治疗的情况进行了回顾性分析。以年龄、性别、身高、体重、美国麻醉医师协会分类、手术年份、病理 N 分期和吻合方法为协变量,按 1:2 的比例对 SIDG 组和 MLDG 组进行倾向评分匹配:经过1:2配对后,研究纳入了接受SIDG(n = 179)和MLDG(n = 358)手术的患者。SIDG组和MLDG组取回的淋巴结数量无明显差异(52.8 ± 19.3 vs. 53.9 ± 21.0,P = 0.56)。SIDG 组的手术时间明显更短(170.8 ± 60.0 分钟 vs 186.1 ± 52.6 分钟,P = 0.004)。两组的术后住院时间相当(SIDG:5.9 ± 3.4 天 vs MLDG:6.3 ± 5.1 天,P = 0.23),术后并发症发生率也相当(SIDG:13.4% vs MLDG:12.8%,P = 0.89):结论:对于超重和肥胖的胃癌患者,SIDG与MLDG一样安全可行,与MLDG相比,术后早期并发症发生率相当,且不影响手术时间。
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Safety and feasibility of single-incision laparoscopic distal gastrectomy in overweight and obese gastric cancer patients: a propensity score-matched analysis.

Background: The technical challenges and safety concerns of single-incision laparoscopic gastrectomy for overweight and obese gastric cancer patients remain unclear. This study aimed to evaluate the safety and feasibility of single-incision laparoscopic distal gastrectomy (SIDG) compared to multiport laparoscopic distal gastrectomy (MLDG) in overweight and obese gastric cancer patients.

Methods: This study retrospectively analyzed overweight and obese patients (body mass index ≥ 25 kg/m2) and pathologic stage T1 primary gastric adenocarcinoma treated with either SIDG or MLDG. The SIDG and MLDG groups were propensity score matched at a 1:2 ratio using age, sex, height, body weight, American Society of Anesthesiologists classification, year of surgery, pathologic N stage, and anastomosis method as covariates.

Results: After 1:2 matching, the study included patients who underwent SIDG (n = 179) and MLDG (n = 358). No significant difference in the number of retrieved lymph nodes was found between the SIDG and MLDG groups (52.8 ± 19.3 vs. 53.9 ± 21.0, P = 0.56). Operation times were significantly shorter in the SIDG group (170.8 ± 60.0 min vs. 186.1 ± 52.6 min, P = 0.004). The postoperative hospital length of stay was comparable between the 2 groups (SIDG: 5.9 ± 3.4 days vs. MLDG: 6.3 ± 5.1 days, P = 0.23), as was postoperative complication rate (SIDG: 13.4% vs. MLDG: 12.8%, P = 0.89).

Conclusions: SIDG was shown to be as safe and feasible as MLDG for overweight and obese gastric cancer patients, with comparable early postoperative complication rates without compromising operation time compared to MLDG.

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来源期刊
Gastric Cancer
Gastric Cancer 医学-胃肠肝病学
CiteScore
14.70
自引率
2.70%
发文量
80
审稿时长
6-12 weeks
期刊介绍: Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide. The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics. Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field. With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.
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