腹腔镜胃切除术与开放式胃切除术在胃癌新辅助化疗患者中的比较:基于韩国胃癌协会全国调查的多中心回顾性研究。

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2023-07-01 DOI:10.5230/jgc.2023.23.e28
Seul Ki Oh, Chang Seok Ko, Seong-A Jeong, Jeong Hwan Yook, Moon-Won Yoo, Beom Su Kim, In-Seob Lee, Chung Sik Gong, Sa-Hong Min, Na Young Kim
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摘要

目的:尽管有科学证据表明腹腔镜胃切除术(LG)可用于晚期胃癌的治疗,但其在接受新辅助化疗的患者中的应用仍不确定。材料和方法:我们使用2019年韩国胃癌协会全国调查数据库,提取489例接受新辅助化疗的原发性胃癌患者的数据。经过倾向评分匹配分析,我们比较了97例LG患者和97例开放式胃切除术(OG)患者的手术结果。我们使用多变量分析调查了术后并发症的危险因素。结果:OG组手术时间明显缩短。LG组患者的失血量明显少于OG组。两组患者的住院时间和术后并发症相似。LG组Clavien-Dindo≥3级并发症发生率与OG组相当(1.03% vs. 4.12%, P=0.215)。两组淋巴结清扫数比较差异无统计学意义(38.60 vs 35.79, P=0.182)。多变量分析确定体重指数(比值比[OR], 1.824;95%置信区间[CI], 1.029-3.234;P=0.040)和切除程度(OR, 3.154;95% ci, 1.084-9.174;P=0.035)是术后并发症的独立危险因素。结论:通过一个大型的全国性多中心调查数据库,我们证明LG和OG在接受新辅助化疗的胃癌患者中具有相当的短期结果。
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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Comparison of Laparoscopic and Open Gastrectomy for Patients With Gastric Cancer Treated With Neoadjuvant Chemotherapy: A Multicenter Retrospective Study Based on the Korean Gastric Cancer Association Nationwide Survey.

Purpose: Despite scientific evidence regarding laparoscopic gastrectomy (LG) for advanced gastric cancer treatment, its application in patients receiving neoadjuvant chemotherapy remains uncertain.

Materials and methods: We used the 2019 Korean Gastric Cancer Association nationwide survey database to extract data from 489 patients with primary gastric cancer who received neoadjuvant chemotherapy. After propensity score matching analysis, we compared the surgical outcomes of 97 patients who underwent LG and 97 patients who underwent open gastrectomy (OG). We investigated the risk factors for postoperative complications using multivariate analysis.

Results: The operative time was significantly shorter in the OG group. Patients in the LG group had significantly less blood loss than those in the OG group. Hospital stay and overall postoperative complications were similar between the two groups. The incidence of Clavien-Dindo grade ≥3 complications in the LG group was comparable with that in the OG group (1.03% vs. 4.12%, P=0.215). No statistically significant difference was observed in the number of harvested lymph nodes between the two groups (38.60 vs. 35.79, P=0.182). Multivariate analysis identified body mass index (odds ratio [OR], 1.824; 95% confidence interval [CI], 1.029-3.234; P=0.040) and extent of resection (OR, 3.154; 95% CI, 1.084-9.174; P=0.035) as independent risk factors for overall postoperative complications.

Conclusions: Using a large nationwide multicenter survey database, we demonstrated that LG and OG had comparable short-term outcomes in patients with gastric cancer who received neoadjuvant chemotherapy.

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