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中国临床研究英文版:2019,32(6):747-750,754
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新辅助化疗联合完全腹腔镜下远端胃癌D2根治术的临床疗效
(1.西南医科大学,四川 泸州 646000;2.四川省人民医院胃肠外科,四川 成都 610072)
Efficacy of neoadjuvant chemotherapy combined with complete laparoscopic D2 radical resection for distal gastric cancer
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Received:October 07, 2018   Published Online:June 20, 2019
中文摘要: 目的 探讨新辅助化疗联合完全腹腔镜下远端胃癌D2根治术的临床疗效及对复发率和死亡率的影响。方法 观察2015年1月至2017年6月预行根治性远端胃切除的72例患者,其中观察组为SOX方案新辅助化疗后行完全腹腔镜根治性远端胃切除的33例患者,对照组为仅行完全腹腔镜根治性远端胃切除的39例患者。分析两组手术时间、术中出血量、中转开腹率、淋巴结清扫数目、术后手术相关并发症、非手术并发症、术后分期、复发及远处转移等临床资料。结果 观察组新辅助化疗有效率54.55%(18/33);观察组患者术后TNM分期与对照组相比较术前下降,差异有统计学意义(P<0.05)。观察组手术时间[(248.0±37.0)min vs (224.9±29.6)min]、术中出血量[(139.4±51.7)ml vs (109.6±48.7)ml]较对照组略有增加,差异具有统计学意义(P<0.05);两组在淋巴结清扫数目和术后并发症等方面对比差异无统计学意义(P>0.05)。随访时间截至2017年10月,与对照组相比,观察组肿瘤复发转移(12.1% vs 41.0%)及死亡率(6.0% vs 76.9%)降低,差异有统计学意义(P<0.05)。结论 新辅助化疗联合完全腹腔镜下远端胃癌D2根治术是安全、可行的,手术创伤更小,恢复快,且短期疗效具有优势。
Abstract:ObjectiveTo explore the clinical efficacy of neoadjuvant chemotherapy(NACT) combined with totally laparoscopic distal gastrectomy with D2 lymphadenectomy. Methods A total of 72 patients undergoing radical distal gastrectomy from January 2015 to June 2017 were enrolled and divided into observation group (n=33) in which totally laparoscopic distal gastrectomy was performed after neoadjuvant chemotherapy with SOX regimen (oxaliplatin combined with tegio capsules) and control group(n=39) in which totally laparoscopic distal gastrectomy was conducted alone.The operation time,intraoperative bleeding volume,rate of conversion to laparotomy,number of lymph node dissection,postoperative complications,non-operative complications,post-operative staging,recurrence and distant metastasis were retrospectively analyzed in two groups. Results The effective rate was 54.55% (18/33) in observation group,and the post-operative TNM stage was significantly lower than that in control group (P<0.05).The operation time [(248.0±37.0) min vs (224.9±29.6) min],intraoperative bleeding [(139.4±51.7) ml vs (109.6±48.7)ml] in observation group were statistically higher than those in control group (all P<0.05).There were no significant differences in lymph node dissection number and postoperative complications between two groups(all P>0.05).The follow-up period ended in October 2017,and the tumor recurrence and metastasis(12.1% vs 41.0%)and mortality(6.0% vs 76.9%)significantly decreased in observation group compared with control group (P<0.05). Conclusion It is concluded that SOX regimen combined totally laparoscopic distal gastrectomy with D2 lymphadenectomy is safe and feasible with less trauma and rapid recovery and has advantage in short-term efficacy.
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