BACKGROUND The standard treatment for advanced T2 gastric cancer(GC)is laparoscopic or surgical gastrectomy(either partial or total)and D2 lymphadenectomy.A novel combined endoscopic and laparoscopic surgery(NCELS)has...BACKGROUND The standard treatment for advanced T2 gastric cancer(GC)is laparoscopic or surgical gastrectomy(either partial or total)and D2 lymphadenectomy.A novel combined endoscopic and laparoscopic surgery(NCELS)has recently been proposed as a better option for T2 GC.Here we describe two case studies demonstrating the efficacy and safety of NCELS.CASE SUMMARY Two T2 GC cases were both resected by endoscopic submucosal dissection and full-thickness resection and laparoscopic lymph nodes dissection.This method has the advantage of being more precise and minimally invasive compared to current methods.The treatment of these 2 patients was safe and effective with no complications.These cases were followed up for nearly 4 years without recurrence or metastasis.CONCLUSION This novel method provides a minimally invasive treatment option for T2 GC,and its potential indications,effectiveness and safety needs to be further evaluated in controlled studies.展开更多
目的比较腹腔镜经腹入路与胸腹腔镜联合入路治疗食管胃连接部腺癌(AEG)的预后效果。方法选择2021年12月-2023年12月该院行AEG切除术,并行淋巴结清扫的患者110例。根据手术方式,将患者分为腹腔镜组(n=62)和胸腹腔镜联合组(n=48)。采用倾...目的比较腹腔镜经腹入路与胸腹腔镜联合入路治疗食管胃连接部腺癌(AEG)的预后效果。方法选择2021年12月-2023年12月该院行AEG切除术,并行淋巴结清扫的患者110例。根据手术方式,将患者分为腹腔镜组(n=62)和胸腹腔镜联合组(n=48)。采用倾向评分匹配(PSM)平衡组间差异,减少潜在混杂因素后,比较两组患者的一般资料、围手术期指标、营养状态指标、术后并发症和术后生存情况;采用广义估计方程(GEE),构建两组患者治疗前后的营养状态相关指标模型;采用Cox比例风险模型,分析治疗方式对AEG患者预后的影响。结果PSM前,两组患者性别、年龄、体重指数(BMI)、TNM分期、肿瘤最大直径和食管侵犯长度比较,差异均有统计学意义(P<0.05)。PSM后,两组患者一般资料比较,差异无统计学意义(P>0.05);胸腹腔镜联合组手术时间、术后卧床时间、术后住院时间明显长于腹腔镜组(P<0.05),术中出血量明显多于腹腔镜组(P<0.05),术后24 h视觉模拟评分法(VAS)明显高于腹腔镜组(P<0.05),淋巴结清扫数量、阳性淋巴结数量、纵隔淋巴结清扫数量和腹腔淋巴结清扫数量明显多于腹腔镜组(P<0.05),血红蛋白(Hb)、白蛋白(ALB)、前白蛋白(PAB)、转铁蛋白(TRF)和体重(W)术前术后差值明显大于腹腔镜组(P<0.05),两组患者术后并发症总发生率和1年生存率比较,差异均无统计学意义(P>0.05);GEE分析结果显示,腹腔镜治疗对Hb和TRF指标影响更大,胸腹腔镜联合治疗对ALB、PAB和W指标影响更大;腹腔镜治疗方式是AEG患者预后良好的保护因素(P<0.05)。结论腹腔镜治疗在手术时间、术后卧床时间、术后住院时间、术中出血量、24 h VAS和术后营养方面占优势;胸腹腔镜联合治疗在淋巴结清扫数量、阳性淋巴结数量,纵隔淋巴结清扫数量和腹腔淋巴结清扫数量方面占优势。综合考虑,腹腔镜治疗的短期预后更好。展开更多
文摘BACKGROUND The standard treatment for advanced T2 gastric cancer(GC)is laparoscopic or surgical gastrectomy(either partial or total)and D2 lymphadenectomy.A novel combined endoscopic and laparoscopic surgery(NCELS)has recently been proposed as a better option for T2 GC.Here we describe two case studies demonstrating the efficacy and safety of NCELS.CASE SUMMARY Two T2 GC cases were both resected by endoscopic submucosal dissection and full-thickness resection and laparoscopic lymph nodes dissection.This method has the advantage of being more precise and minimally invasive compared to current methods.The treatment of these 2 patients was safe and effective with no complications.These cases were followed up for nearly 4 years without recurrence or metastasis.CONCLUSION This novel method provides a minimally invasive treatment option for T2 GC,and its potential indications,effectiveness and safety needs to be further evaluated in controlled studies.
文摘目的比较腹腔镜经腹入路与胸腹腔镜联合入路治疗食管胃连接部腺癌(AEG)的预后效果。方法选择2021年12月-2023年12月该院行AEG切除术,并行淋巴结清扫的患者110例。根据手术方式,将患者分为腹腔镜组(n=62)和胸腹腔镜联合组(n=48)。采用倾向评分匹配(PSM)平衡组间差异,减少潜在混杂因素后,比较两组患者的一般资料、围手术期指标、营养状态指标、术后并发症和术后生存情况;采用广义估计方程(GEE),构建两组患者治疗前后的营养状态相关指标模型;采用Cox比例风险模型,分析治疗方式对AEG患者预后的影响。结果PSM前,两组患者性别、年龄、体重指数(BMI)、TNM分期、肿瘤最大直径和食管侵犯长度比较,差异均有统计学意义(P<0.05)。PSM后,两组患者一般资料比较,差异无统计学意义(P>0.05);胸腹腔镜联合组手术时间、术后卧床时间、术后住院时间明显长于腹腔镜组(P<0.05),术中出血量明显多于腹腔镜组(P<0.05),术后24 h视觉模拟评分法(VAS)明显高于腹腔镜组(P<0.05),淋巴结清扫数量、阳性淋巴结数量、纵隔淋巴结清扫数量和腹腔淋巴结清扫数量明显多于腹腔镜组(P<0.05),血红蛋白(Hb)、白蛋白(ALB)、前白蛋白(PAB)、转铁蛋白(TRF)和体重(W)术前术后差值明显大于腹腔镜组(P<0.05),两组患者术后并发症总发生率和1年生存率比较,差异均无统计学意义(P>0.05);GEE分析结果显示,腹腔镜治疗对Hb和TRF指标影响更大,胸腹腔镜联合治疗对ALB、PAB和W指标影响更大;腹腔镜治疗方式是AEG患者预后良好的保护因素(P<0.05)。结论腹腔镜治疗在手术时间、术后卧床时间、术后住院时间、术中出血量、24 h VAS和术后营养方面占优势;胸腹腔镜联合治疗在淋巴结清扫数量、阳性淋巴结数量,纵隔淋巴结清扫数量和腹腔淋巴结清扫数量方面占优势。综合考虑,腹腔镜治疗的短期预后更好。
