조기 위암에서 복강경 보조 위 절제술과 개복술의 비교 연구
Laparoscopy-assisted Billroth I Gastrectomy Compared with Open Gastrectomy
이남준, 한호성, 김영우, 민석기, 김유진, 최용만,
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이남준 ( Yi Nam-Joon )
이화여자대학교 의과대학 외과학교실
한호성 ( Han Ho-Seong )
이화여자대학교 의과대학 외과학교실
김영우 ( Kim Young-Woo )
이화여자대학교 의과대학 외과학교실
민석기 ( Min Seog-Ki )
이화여자대학교 의과대학 외과학교실
김유진 ( Kim Eu-Gene )
이화여자대학교 의과대학 외과학교실
최용만 ( Choi Yong-Man )
이화여자대학교 의과대학 외과학교실
KMID : 0371320010610020164
Abstract
Purpose
To compare laparoscopy-assisted Billroth I gastrectomy (LABIG) including standard lymph node dissection for patients with early gastric cancer was compared with open gastrectomy as a treatment method.
Methods
A prospective nonrandomized study was performed of early gastric cancer patients at Ewha Womans University Mok-Dong hospital from July 1999 to May 2001. Twenty patients (Group L) underwent LABIG including standard lymph node dissection. The
control
group (Group O) comprised 14 patients with conventional open radical subtotal gastrectomy and Billroth I anastomosis.
Results
In group L, pathologic reports revealed 18 early gastric cancers (stage IA 17 cases, IB 1 case), and 2 pm cancers (stage IB 1 case, stage II 1 case). In group O, there were 13 early gastric cancers (stage IA 12 cases, IB 1 case), and 1 pm cancer
(stage
IB). Significant differences (p＜0.05) were present between group L and O in regards to mean operation time (277.5 vs 215.0 minutes), proximal margin (4.8 vs 7.0 cm), distal margin (4.4 vs 3.9 cm), number of harvested lymph nodes (25.6 vs 37.9),
frequencies for pain control (7.2 vs 11.0 times), wound size (7.6 vs 20.0 cm) and postoperative hospital stay (13.7 vs 21.9 days). There were no differences in blood loss, transfusion, leukocyte count, time to diet, serum protein, or weight loss.
Complications were seen in 2 cases in group L (enterocutaneous fistula, gastric atony), and 2 cases in group O (gastric atony, marginal ulcer with bleeding).
Conclusion
LABIG with standard lymph node dissectionsis a safe and useful technique for the treatment of early gastric cancer with improved postoperative recovery as compared to open conventional gastrectomy.
키워드
복강경 보조 위 절제술; 림프절 절제술; 조기 위암; Laparoscopy-assisted gastrectomy; Lymph node dissection; Early gastric cancer;
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