微创外科联合前哨淋巴结活检术治疗早期胃癌  

Laparoscopic sentinel node biopsy guided minimally invasive surgery for the treatment of early gastric cancer

作　　者：史俊峰[1] 许示心[1] 费伯健[1] 屠惠明[2] 

机构地区：[1]江南大学附属医院(无锡市第四人民医院)普通外科,江苏省214000 [2]江南大学附属医院(无锡市第四人民医院)消化内科,江苏省214000

出　　处：《中华普通外科杂志》2015年第10期766-769,共4页Chinese Journal of General Surgery

摘　　要：目的探讨微创外科联合前哨淋巴结活检术治疗早期胃癌的可行性及临床疗效。方法对2008年12月至2014年1月在江南大学附属医院行微创外科联合前哨淋巴结活检术治疗早期胃癌39例患者的临床资料进行回顾性分析。结果本组39例早期胃癌患者中36例行前哨淋巴结活检＋内镜下黏膜剥离术，3例行前哨淋巴结活检＋腹腔镜远端胃癌D，根治术。前哨淋巴结平均（2．8±1．0）枚，前哨淋巴结检出率为100％，阳性率为8％，淋巴结状态评估准确率为100％。无假阴性。内镜下黏膜剥离术组有2例患者分别出现局部复发和肝转移，腹腔镜组有1例患者出现肝、肺转移。本组总无病生存率为95％。结论微创外科联合前哨淋巴结活检术治疗早期胃癌是安全、有效的，在根治肿瘤的前提下最大限度地改善了患者术后生存质量。Objective To evaluate the feasibility and clinical efficacy of minimally invasive surgery combined with sentinel lymph node （SLN） biopsy for early gastric cancer （EGC）. Methods The clinical data of 39 EGC patients undergoing minimally invasive surgery combined with sentinel lymph node biopsy from December 2008 to January 2014 were analyzed retrospectively, Results 36 SLN negative EGC patients received endoscopic submueosal dissection （ ESD ） , and 3 SLN positive EGC patients underwent laparoscopic distal gastrectomy with D2 dissection. The mean number of SLN was （ 2. 8± 1.0）. The SLN detection rate and accuracy of determination of lymph node （LN） status were both 100%. The rate of LN metastasis in patients with EGC was 8% with no false negative rate. In ESD group, local recurrence and liver metastasis developed in one each cases. Meanwhile 1 patient in laparoscopic group sufferd postoperative liver and lung metastasis. Total disease free survival was 95%. Condusions Minimally invasive surgery combined with sentinel lymph node biopsy for EGC is both safe and feasible.

关 键 词：胃肿瘤 前哨淋巴结活组织检查 腹腔镜检查 

分 类 号：R735.2[医药卫生—肿瘤]