دورية أكاديمية
أعرض في EDS

Gastrectomy with Extended Lymphadenectomy: a North American Perspective.

التفاصيل البيبلوغرافية
العنوان: Gastrectomy with Extended Lymphadenectomy: a North American Perspective.
المؤلفون: Gosselin-Tardif A; Department of General Surgery, McGill University Health Centre, Montreal, QC, Canada. alexandre.gosselin-tardif@mail.mcgill.ca., Lie J; Department of General Surgery, McGill University Health Centre, Montreal, QC, Canada., Nicolau I; Division of Thoracic Surgery, McGill University Health Centre, Montreal, QC, Canada., Molina JC; Division of Thoracic Surgery, McGill University Health Centre, Montreal, QC, Canada., Cools-Lartigue J; Division of Thoracic Surgery, McGill University Health Centre, Montreal, QC, Canada., Feldman L; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada., Spicer J; Division of Thoracic Surgery, McGill University Health Centre, Montreal, QC, Canada., Mueller C; Division of Thoracic Surgery, McGill University Health Centre, Montreal, QC, Canada., Ferri L; Division of Thoracic Surgery, McGill University Health Centre, Montreal, QC, Canada.
المصدر: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2018 Mar; Vol. 22 (3), pp. 414-420. Date of Electronic Publication: 2017 Nov 09.
نوع المنشور: Comparative Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier B.V Country of Publication: United States NLM ID: 9706084 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4626 (Electronic) Linking ISSN: 1091255X NLM ISO Abbreviation: J Gastrointest Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: 2024-: [Amsterdam] : Elsevier B.V.
Original Publication: St. Louis, MO : Quality Medical Pub., c1997-
مواضيع طبية MeSH: Gastrectomy*, Adenocarcinoma/*surgery , Lymph Node Excision/*methods , Lymph Nodes/*surgery , Stomach Neoplasms/*surgery, Adenocarcinoma/pathology ; Aged ; Aged, 80 and over ; Databases, Factual ; Dissection ; Female ; Humans ; Lymph Nodes/pathology ; Male ; Middle Aged ; Quebec ; Stomach Neoplasms/pathology
مستخلص: Purpose: Despite evidence of oncologic benefits from extended (D2) lymphadenectomy in gastric cancer from many East Asian studies, there is persistent debate over its use in the West, mainly due to perceived high rates of morbidity and mortality. This study evaluates the safety and efficacy of D2 dissection in a high-volume North American center.
Methods: A prospectively entered database of all patients undergoing gastrectomy for cancer at a North American referral center from 2005 to 2016 was reviewed. Wedge resections, thoracoabdominal approach, emergency surgery, palliative operations, and non-adenocarcinoma cases were excluded.
Results: Of 366 non-bariatric gastrectomies over this period, 175 met the inclusion criteria. Median age was 73 years and 69% were male. One hundred forty-one patients (80%) underwent D2 dissection, the rest having D1. There was no difference in postoperative complications (D1 = 44%: D2 = 42%), anastomotic leaks (D1 = 6%: D2 = 5%), and same-admission or 30-day mortality (D1 = 6%: D2 = 2%). D2 dissection was associated with higher pathological stage (72% > stage 1 vs 38% > stage 1; p < 0.05) and median lymph node yield (30 vs 14; p < 0.05), with no difference in complete resection (R0) rate (D1 = 98% vs D2 = 92%). Laparoscopic approach was employed in 34% (45/141) of D2 cases, resulting in shorter median length of stay (6 days vs 9; p < 0.05) and equivalent oncologic outcomes compared to open D2.
Conclusion: This study supports the use of D2 lymphadenectomy, by either open or laparoscopic approach, in high-volume North American centers as a safe and effective oncologic procedure for gastric cancer, with equivalent complication rates and superior lymph node yield to traditional D1 dissection.
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فهرسة مساهمة: Keywords: Gastrectomy; Gastric cancer; Lymphadenectomy
تواريخ الأحداث: Date Created: 20171111 Date Completed: 20190514 Latest Revision: 20240213
رمز التحديث: 20240213
DOI: 10.1007/s11605-017-3633-5
PMID: 29124550
قاعدة البيانات: MEDLINE
الوصف
تدمد:1873-4626
DOI:10.1007/s11605-017-3633-5