Clinical Effect of Keeping The Pancreatic Capsule in Radical Gastrectomy for Early Stage of Gastric Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 WANGYi-fei ,  XUEJun , WANGYan-fei

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei Province, China;

Corresponding?author：

XUEJun, Email: xuejun2014@163.com

Keywords：

Gastric cancer; Keeping the pancreatic capsule in radical gastrectomy; Traditionally radical gastrectomy; Clinical effect

DOI：

10.7507/1007-9424.20150284

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the clinical effect of keeping the pancreatic capsule in radical gastrectomy for early stage of gastric cancer. Methods Two hundreds and seven patients with early stage of gastric cancer who were treated in our hospital from Jan 2011 to December 2011 were enrolled prospectively, and were divided into experimental group (n=95) and control group (n=112). Patients in experimental group kept the pancreatic capsule in radical gastrec-tomy, but patients in control group didn't keep the pancreatic capsule. Comparison of the clinical effect between the 2 groups was performed. Results The blood loss[(134.1±5.3) mL vs. (150.3±3.7) mL] and operation time[(76.4±5.7) min vs. (87.5±9.1) min]of experimental group were all lower or shorter than those of control group (P<0.05), but there were no significant difference between the 2 groups in incidence of total complication[7.37% (7/95) vs. 10.71% (12/112)], stomal leak[3.16% (3/95) vs. 4.46% (5/112)], and anastomotic stenosis[4.21% (4/95) vs. 6.25% (7/112)], P>0.05. All of the 207 patients were followed-up for 1-36 months, with the median time of 17.5 months. During the follow-up period, in experimental group, there were 30 patients suffered from recurrence, 23 patients suffered from metastasis, and 44 patients died, and the 1-and 3-year survival rates was 84.21% (80/95) and 53.68% (51/95) respectively, 1- and 3-year disease free survival rates was 80.00% (76/95) and 48.42% (46/95) respectively; in control group, there were 37 patients suffered from recurrence, 23 patients suffered from metastasis, and 49 patients died, and the 1-and 3-year survival rates was 85.71% (96/112) and 56.25% (63/112) respectively, 1-and 3-year disease free survival rates was 81.25% (91/112) and 49.11% (55/112) respectively. There were no significant difference in the 1-and 3-year survival rate, 1-and 3-year disease free survival rate (P>0.05). In addition, there were no significant difference in the survival and disease free survival situation (P>0.05). Conclusions Survival and disease free survival situation of keeping the pancreatic capsule in radical gastrectomy is similar with traditionally radical gastrectomy, but surgery of keeping the pancreatic capsule in radical gastrectomy has the advantages of less bleeding and shorter operation time, which is worthy of further study.

Citation： WANGYi-fei, XUEJun, WANGYan-fei. Clinical Effect of Keeping The Pancreatic Capsule in Radical Gastrectomy for Early Stage of Gastric Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(9): 1096-1100. doi: 10.7507/1007-9424.20150284 Copy

1.	?黎介壽, 吳孟超, 黃志強. 普通外科手術學. 第2版. 北京:人民軍醫出版社, 2012:300-304.
2.	韓方海, 詹文華, 何裕隆, 等. 胃癌根治手術網膜囊及筋膜切除問題. 中國普外基礎與臨床雜志, 2007, 14(2):230-234.
3.	Doglietto GB, Pacelli F, Caprino P, et al. Pancreas-preserving total gastrectomy for gastric cancer. Arch Surg, 2000, 135(1):89-94.
4.	孫振青, 周巖冰. 常規檢查淋巴結陰性No.7組胃癌患者的淋巴結微轉移研究. 中華胃腸外科雜志, 2005, 8(4):339-342.
5.	丁明鋒, 許軍, 劉昶, 等. 胃癌根治術胰腺被膜清除的探討. 外科理論與實踐, 2010, 15(6):641-645.
6.	陳若華, 汪灝, 王萌, 等. 網膜囊切除在胃癌根治術中意義的研究進展. 醫藥前沿, 2012, 2(2):24-25.
7.	畢建威, 杜成輝, 魏國, 等. 胃癌根治術中切除胰腺被膜及橫結腸系膜前葉的臨床意義. 中華胃腸外科雜志, 2009, 12(5):467-470.
8.	Kitano S, Shiraishi N. Current status of laparoscopic gastrectomy for cancer in Japan. Surg Endosc, 2004, 18(2):182-185.
9.	Shiraishi N, Yasuda K, Kitano S. Laparoscopic gastrectomy with lymph node dissection for gastric cancer. Gastric Cancer, 2006, 9(3):167-176.
10.	劉青, 孫念緒, 龍贅. 腹腔鏡在胃癌根治術中的應用. 腹腔鏡外科雜志, 2006, 11(2):95-97.
11.	余佩武, 羅華星. 腹腔鏡胃癌根治術:未來治療胃癌的標準手術. 第三軍醫大學學報, 2013, 35(18):1889-1892.
12.	Huscher CG, Mingoli A, Sgarzini G, et al. Laparoscopic versus open subtotal gastrectomy for distal gastric cancer:five-year results of a randomized prospective trial. Ann Surg, 2005, 241(2):232-237.
13.	Degiuli M, Sasako M, Ponti A, et al. Survival results of a multicentre phase Ⅱ study to evaluate D2 gastrectomy for gastric cancer. Br J Cancer, 2004, 90(9):1727-1732.
14.	陳曉秋, 劉楠楠. 胃癌術后FOLFOX6方案與XELOX方案輔助化療的生存比較. 中國腫瘤臨床, 2014, 41(18):1195-1198.
15.	Thrumurthy SG, Chaudry MA, Hochhauser D, et al. The diagnosis and management of gastric cancer. BMJ, 2013, 347:f6367.
16.	Nagini S. Carcinoma of the stomach:a review of epidemiology, pathogenesis, molecular genetics and chemoprevention. World J Gastrointest Oncol, 2012, 4(7):156-169.
17.	Miceli R, Tomasello G, Bregni G, et al. Adjuvant chemotherapy for gastric cancer:current evidence and future challenges. World J Gastroenterol, 2014, 20(16):4516-4525.
18.	季加孚. 不斷提高我國胃癌規范化治療水平. 中華普外科手術學雜志:電子版, 2013, 7(1):1-3.
19.	陳榮海. 胰腺被膜及橫結腸系膜前葉切除在胃癌根治術中的短期療效及癌轉移因素分析. 中國醫師進修雜志, 2012, 35(29):6-8.
20.	Ziogas D, Baltogiannis G, Fatouros M. Continuing debate on D2 lymphadenectomy for gastric cancer. World J Surg, 2008, 32(9):2127-2128.
21.	Liakakos T, Roukos DH. More controversy than ever-challenges and promises towards personalized treatment of gastric cancer. Ann Surg Oncol, 2008, 15(4):956-960.
22.	Mcculloch P, Niita ME, Kazi H, et al. Gastrectomy with extended lymphadenectomy for primary treatment of gastric cancer. Br J Surg, 2005, 92(1):5-13.
23.	田大宇, 張松海, 胡祥. 338例早期胃癌的臨床分析. 中國醫師進修雜志, 2011, 34(2):21-24.
24.	韋皓棠, 董保國, 李霖, 等. 胃癌橫結腸系膜前葉及胰腺被膜轉移的危險因素分析. 廣西醫學, 2014, 36(7):927-929.
25.	Shchepotin IB, Evans SR, Chorny VA, et al. Postoperative complica-tions requiring relaparotomies after 700 gastretomies performed for gastric cancer. Am J Surg, 1996, 171(2):270-273.
26.	Chernyi VA, Shchepotin IB. Ways of reducing the main postopera-tive complications of gastrectomy in patients with gastric cancer. Vestn Khir Im I I Grek, 1987, 138(6):102-104.
27.	陳明敏, 朱正綱, 燕敏, 等. 胃癌術后早期并發重癥急性胰腺炎的原因及其診治. 上海交通大學學報:醫學版, 2007, 27(5):566-568.
28.	李世寬, 周巖冰, 于冠君. 遠端胃大部切除術后胃排空延遲低發生率分析. 青島大學醫學院學報, 2003, 39(3):263-264, 267.
29.	程建淵, 薛偉山. 殘胃功能性排空障礙的治療. 齊魯醫學雜志, 2004, 19(5):421-422.
30.	胡祥. 胃癌外科手術的基本技術和科學基礎. 中國醫師進修雜志, 2009, 32(14):1-3.
31.	Badgwell B, Cormier JN, Xing Y, et al. Attempted salvage resectio-nfor recurrent gastric or gastroesophageal cancer. Ann Surg Oncol, 2009, 16(1):42-50.

1. ?黎介壽, 吳孟超, 黃志強. 普通外科手術學. 第2版. 北京:人民軍醫出版社, 2012:300-304.
2. 韓方海, 詹文華, 何裕隆, 等. 胃癌根治手術網膜囊及筋膜切除問題. 中國普外基礎與臨床雜志, 2007, 14(2):230-234.
3. Doglietto GB, Pacelli F, Caprino P, et al. Pancreas-preserving total gastrectomy for gastric cancer. Arch Surg, 2000, 135(1):89-94.
4. 孫振青, 周巖冰. 常規檢查淋巴結陰性No.7組胃癌患者的淋巴結微轉移研究. 中華胃腸外科雜志, 2005, 8(4):339-342.
5. 丁明鋒, 許軍, 劉昶, 等. 胃癌根治術胰腺被膜清除的探討. 外科理論與實踐, 2010, 15(6):641-645.
6. 陳若華, 汪灝, 王萌, 等. 網膜囊切除在胃癌根治術中意義的研究進展. 醫藥前沿, 2012, 2(2):24-25.
7. 畢建威, 杜成輝, 魏國, 等. 胃癌根治術中切除胰腺被膜及橫結腸系膜前葉的臨床意義. 中華胃腸外科雜志, 2009, 12(5):467-470.
8. Kitano S, Shiraishi N. Current status of laparoscopic gastrectomy for cancer in Japan. Surg Endosc, 2004, 18(2):182-185.
9. Shiraishi N, Yasuda K, Kitano S. Laparoscopic gastrectomy with lymph node dissection for gastric cancer. Gastric Cancer, 2006, 9(3):167-176.
10. 劉青, 孫念緒, 龍贅. 腹腔鏡在胃癌根治術中的應用. 腹腔鏡外科雜志, 2006, 11(2):95-97.
11. 余佩武, 羅華星. 腹腔鏡胃癌根治術:未來治療胃癌的標準手術. 第三軍醫大學學報, 2013, 35(18):1889-1892.
12. Huscher CG, Mingoli A, Sgarzini G, et al. Laparoscopic versus open subtotal gastrectomy for distal gastric cancer:five-year results of a randomized prospective trial. Ann Surg, 2005, 241(2):232-237.
13. Degiuli M, Sasako M, Ponti A, et al. Survival results of a multicentre phase Ⅱ study to evaluate D2 gastrectomy for gastric cancer. Br J Cancer, 2004, 90(9):1727-1732.
14. 陳曉秋, 劉楠楠. 胃癌術后FOLFOX6方案與XELOX方案輔助化療的生存比較. 中國腫瘤臨床, 2014, 41(18):1195-1198.
15. Thrumurthy SG, Chaudry MA, Hochhauser D, et al. The diagnosis and management of gastric cancer. BMJ, 2013, 347:f6367.
16. Nagini S. Carcinoma of the stomach:a review of epidemiology, pathogenesis, molecular genetics and chemoprevention. World J Gastrointest Oncol, 2012, 4(7):156-169.
17. Miceli R, Tomasello G, Bregni G, et al. Adjuvant chemotherapy for gastric cancer:current evidence and future challenges. World J Gastroenterol, 2014, 20(16):4516-4525.
18. 季加孚. 不斷提高我國胃癌規范化治療水平. 中華普外科手術學雜志:電子版, 2013, 7(1):1-3.
19. 陳榮海. 胰腺被膜及橫結腸系膜前葉切除在胃癌根治術中的短期療效及癌轉移因素分析. 中國醫師進修雜志, 2012, 35(29):6-8.
20. Ziogas D, Baltogiannis G, Fatouros M. Continuing debate on D2 lymphadenectomy for gastric cancer. World J Surg, 2008, 32(9):2127-2128.
21. Liakakos T, Roukos DH. More controversy than ever-challenges and promises towards personalized treatment of gastric cancer. Ann Surg Oncol, 2008, 15(4):956-960.
22. Mcculloch P, Niita ME, Kazi H, et al. Gastrectomy with extended lymphadenectomy for primary treatment of gastric cancer. Br J Surg, 2005, 92(1):5-13.
23. 田大宇, 張松海, 胡祥. 338例早期胃癌的臨床分析. 中國醫師進修雜志, 2011, 34(2):21-24.
24. 韋皓棠, 董保國, 李霖, 等. 胃癌橫結腸系膜前葉及胰腺被膜轉移的危險因素分析. 廣西醫學, 2014, 36(7):927-929.
25. Shchepotin IB, Evans SR, Chorny VA, et al. Postoperative complica-tions requiring relaparotomies after 700 gastretomies performed for gastric cancer. Am J Surg, 1996, 171(2):270-273.
26. Chernyi VA, Shchepotin IB. Ways of reducing the main postopera-tive complications of gastrectomy in patients with gastric cancer. Vestn Khir Im I I Grek, 1987, 138(6):102-104.
27. 陳明敏, 朱正綱, 燕敏, 等. 胃癌術后早期并發重癥急性胰腺炎的原因及其診治. 上海交通大學學報:醫學版, 2007, 27(5):566-568.
28. 李世寬, 周巖冰, 于冠君. 遠端胃大部切除術后胃排空延遲低發生率分析. 青島大學醫學院學報, 2003, 39(3):263-264, 267.
29. 程建淵, 薛偉山. 殘胃功能性排空障礙的治療. 齊魯醫學雜志, 2004, 19(5):421-422.
30. 胡祥. 胃癌外科手術的基本技術和科學基礎. 中國醫師進修雜志, 2009, 32(14):1-3.
31. Badgwell B, Cormier JN, Xing Y, et al. Attempted salvage resectio-nfor recurrent gastric or gastroesophageal cancer. Ann Surg Oncol, 2009, 16(1):42-50.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Effect of Keeping The Pancreatic Capsule in Radical Gastrectomy for Early Stage of Gastric Cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content