지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2019.12
- 수록면
- 49 - 55 (7page)
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Purpose: Preoperative endoscopic clipping is a popular method in identifying the location of tumors during total laparoscopic or robotic gastrectomy. We investigated the usefulness of additional intraoperative abdominal radiographs to identify the location of clips.
Methods: We retrospectively analyzed 331 patients with early gastric cancer who underwent endoscopic clipping before total laparoscopic or robotic gastrectomy between September 2012 and September 2018. Endoscopists applied two clips 1 cm from the proximal aspect of the upper margin of the tumor which was located above the angle of the stomach. We compared outcomes of patients who underwent preoperative abdominal radiographs only (group A) and those who underwent additional abdominal radiographs (group B).
Results: Of the total patients, 80 (24.2%) underwent additional intraoperative abdominal radiographs. The rates of positive frozen biopsy in the two groups were not significantly different (group A vs. group B: 2.8% vs. 3.8%, P=0.456). The additional resection rate was significantly higher in group B compared to group A (8.8% vs. 2.8%, P=0.048). The mean distance from the tumor was 3.3 cm (±2.4) in group A and 2.4 cm (±1.3) in group B (P<0.001). Large tumor size (≥2.4 cm) was significantly associated with additional resection (odds ratio, 5.53; 95% confidence interval, 1.17–26.30; P=0.031).
Conclusion: Additional intraoperative abdominal radiographs may be unnecessary for confirmation of proximal resection margin, if the resection line can be predetermined with preoperative abdominal radiographs. For large tumors, to avoid additional resection, the resection line should be placed 1 cm or more proximally from the preoperatively applied clips.
Methods: We retrospectively analyzed 331 patients with early gastric cancer who underwent endoscopic clipping before total laparoscopic or robotic gastrectomy between September 2012 and September 2018. Endoscopists applied two clips 1 cm from the proximal aspect of the upper margin of the tumor which was located above the angle of the stomach. We compared outcomes of patients who underwent preoperative abdominal radiographs only (group A) and those who underwent additional abdominal radiographs (group B).
Results: Of the total patients, 80 (24.2%) underwent additional intraoperative abdominal radiographs. The rates of positive frozen biopsy in the two groups were not significantly different (group A vs. group B: 2.8% vs. 3.8%, P=0.456). The additional resection rate was significantly higher in group B compared to group A (8.8% vs. 2.8%, P=0.048). The mean distance from the tumor was 3.3 cm (±2.4) in group A and 2.4 cm (±1.3) in group B (P<0.001). Large tumor size (≥2.4 cm) was significantly associated with additional resection (odds ratio, 5.53; 95% confidence interval, 1.17–26.30; P=0.031).
Conclusion: Additional intraoperative abdominal radiographs may be unnecessary for confirmation of proximal resection margin, if the resection line can be predetermined with preoperative abdominal radiographs. For large tumors, to avoid additional resection, the resection line should be placed 1 cm or more proximally from the preoperatively applied clips.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (13)
참고문헌 신청
Japanese Gastric Cancer Association / 2017 / Japanese gastric cancer treatment guidelines 2014 (ver. 4) / Gastric Cancer 20:1~19
Kim HH / 2019 / Effect of laparoscopic distal gastrectomy vs open distal gastrectomy on longterm survival among patients with stage I gastric cancer: the KLASS-01 randomized clinical trial / JAMA Oncol 5:5~506
Japanese Gastric Cancer Association / 2011 / Japanese classification of gastric carcinoma: 3rd English edition / Gastric Cancer 14:101~112
Ryu KW / 2003 / Preoperative endoscopic clipping:localizing technique of early gastric cancer / J Surg Oncol 82:75~77
Hur H / 2016 / Intraoperative gastroscopy for tumor localization in laparoscopic surgery for gastric adenocarcinoma / J Vis Exp (114):53170
Kim HH / 2019 / Effect of laparoscopic distal gastrectomy vs open distal gastrectomy on longterm survival among patients with stage I gastric cancer: the KLASS-01 randomized clinical trial / JAMA Oncol 5:5~506
Japanese Gastric Cancer Association / 2011 / Japanese classification of gastric carcinoma: 3rd English edition / Gastric Cancer 14:101~112
Ryu KW / 2003 / Preoperative endoscopic clipping:localizing technique of early gastric cancer / J Surg Oncol 82:75~77
Hur H / 2016 / Intraoperative gastroscopy for tumor localization in laparoscopic surgery for gastric adenocarcinoma / J Vis Exp (114):53170
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