演題抄録

ポスター

開催概要
開催回
第56回・2018年・横浜
 

腹腔鏡下胃全摘術の短期・長期成績

演題番号 : P9-1

[筆頭演者]
演者)棚橋 利行:1 
[共同演者]
山口 和也:1、安福 至:1、今井 健晴:1、松井 聡:1、今井 寿:1、加藤 充純:1、田中 善宏:1、松橋 延壽:1、高橋 孝夫:1、吉田 和弘:1

1:岐阜大学・腫瘍外科

 

«Background»Recently, laparoscopic gastrectomy has been increasing in Japan. However, laparoscopic total gastrectomy(LTG) has concerns about the technical difficulty and oncological safety. In addition, there is no standard or superior method for esophagojejunostomy in LTG. This study aimed to determine the surgical and oncological outcomes of LTG in our department.
«Methods»39 patients who underwent curative LTG between January 2001 to December 2017 were enrolled in this study. Patients' characteristics, method for esophagojejunostomy, postoperative surgical outcomes, prognosis and neutritional state after one year were retrospectively assessed.
«Results»Average age was 67.3 years (range;36-87 years), and male-to-female ratio was 22 :17. Average BMI was 21.65 kg/m2. Operation time(median) was 331 min and bleeding(median) was 50 ml. Method for esophagojejunostomy was using circular stapler in 7 cases and linear stapler in 32 cases. Pathological findings of the resected tumors were intestinal type in 29 tumors and diffused type in 21 tumors. 10 cases were duplication tumors. Depth of tumor was M in 23 tumors, SM in 20 tumors, MP in 4 tumors, SS in 1 tumor and SE in 2 tumors. Average tumor size was 58.2mm. Retrieved lymph nodes were 44.2 pieces. The incidence of Clavien-Dindo classification grade IIIa or grater was only one obstructive ileus. Postoperative hospital stay was 13.3 days. Prognosis was very good. Only two patients died. The neutritional state after one year was acceptable.
«Consideration»LTG requires a long operation time but less bleeding. Lymph node dissection is also possible as much as open laparotomy, and there are few postoperative complications. We aim to expand adaptation to advanced cancer by completing the standardization of the procedure.

キーワード

臓器別:胃・十二指腸

手法別:内視鏡手術

前へ戻る