조기 위암의 근치적 위절제술에서 표준 복강경 보조 술식과 Hand-assisted Laparoscopic Surgery의 비교 연구
Laparoscopy-assisted Billroth Ⅰ Gastrectomy Compared with Hand-assisted Laparoscopic Surgery for Early Gastric Cancer -A Prospective Study-
이남준, 김영우, 한호성,
소속 상세정보
이남준 ( Yi Nam-Joon )
이화여자대학교 의과대학 외과학교실
김영우 ( Kim Young-Woo )
이화여자대학교 의과대학 외과학교실
한호성 ( Han Ho-Seong )
이화여자대학교 의과대학 외과학교실
KMID : 0371320020620010057
Abstract
Purpose : To compare standard laparoscopy-assisted Billroth Ⅰ gastrectomies including standard lymph node dissection (LABIG) with hand-assisted laparoscopic surgery with the HandPort system (HALS) for the removal of early gastric cancers
(EGC).
Methods : A prospective study was performed on 26 patients of EGC at Ewha Womans University Mok-Dong Hospital from July 1999 to August 2001. Seventeen patients (Group L) received LABIG using conventional laparoscopy-assisted methods and 9
patients received LABIG using HALS (Group H). We used staplers for the anastomosis, and a standard D2 lymph node dissection was done with ultrasonic shears or electrocautery.
Results : In group L, pathologic reports revealed 14 EGC (stage IA 14 cases), and 3 pm cancers (stage IB 1 case, II 2 cases). In group H, there were 9 early gastric cancers (stage IA 8 cases, IB 1 case). Significant differences (P<0.05)
were
present between group L and H in regards to the number of harvested lymph nodes (30.8 vs 18.9), estimated blood loss (462.1 vs 286.7 ㎖) and postoperative transfusion amounts (0.59 vs 0 unit). There were no differences in the mean operating time,
distance from the lesion to the resection margin, postoperative leukocyte count, frequencies for pain control, wound size, time to diet, weight loss, serum protein, and postoperative hospital stay. Complications were present in 1 case in group L
(enterocutaneous fistula) and 1 case in group H (gastric atony). There was one conversion to open surgery in group H.
Conclusion : LABIG including standard lymph node dissections with both standard laparoscopic surgery and HALS were performed with equal outcome. The choice of surgical method depends on the characteristics of the lesion and the patient’s
physical
factors.
키워드
복강경 보조 위 절제술; Hand-assisted laparoscopic surgery; 조기 위암; Laparoscopy-assisted Billroth Ⅰ gastrectomy; Hand-assisted laparoscopic surgery; Early gastric cancer;
원문 및 링크아웃 정보
등재저널 정보