위암 수술에서 복강경 D2 림프절 절제의 적절성

• Published in: Journal of minimally invasive surgery pp. 121 - 125
• Main Authors: 안훈, 조현진, 김홍주, 박인석, 곽금희, 양근호, 배병노, 김기환, 한세환, 김영덕
• Format: Journal Article
• Language: Korean
• Published: 대한내시경복강경외과학회 01.12.2012
• Subjects: 일반외과학
• ISSN: 2234-778X; 2234-5248

Purpose: There is still debate regarding the suitability of extension of laparoscopic gastrectomy to advanced gastric cancer. Due to the development of new instruments and techniques,several studies are being conducted to extend the range of laparoscopic gastrectomy. This study was conducted to investigate the appropriateness of laparoscopic D2 lymph node dissection for the treatment of gastric cancer from an oncology perspective. Methods: A total of 109 patients, 50 of whom had undergone laparoscopy assisted distal gastrectomy (LADG) and 59 patients who underwent open distal gastrectomy (ODG), that were operated on by a single surgeon in the surgery department of Sanggye Paik Hospital from April 2009 to May 2011were analyzed. All patients underwent D2 lymph node dissection. The clinical characteristics of patients, surgical outcomes and clinicopathologic findings were then compared and analyzed. Results: There was no significant difference in the operation time between the two groups (252.70±40.81 vs. 252.20±45.22,p=0.698). The day 1 post operation hemoglobin was higher in the LADG group than the ODG group (12.52±1.53 vs. 10.54±1.57,p=0.011). There were nosignificant differences in resection margin (6.89±2.25 vs. 7.20±3.42, p=0.254, 4.05±2.57 vs. 3.68±2.74, p=0.254)or total number of harvested lymph nodes (30.36±10.67 vs. 35.44±12.56, p=0.508) between groups. Conclusion: In stomach cancer surgery, both ODG and LADG can be used to conduct lymph node dissection. Therefore,if the stability and feasibility of LADG is confirmed by prospective studies at multiple centers, laparoscopic gastrectomy may be extended to advanced gastric cancer as well. KCI Citation Count: 1