Application of en-bloc lymph node dissection in laparoscopic radical resection for gallbladder cancer
10.3760/cma.j.cn113884-20220912-00355
- VernacularTitle:En-bloc淋巴结清扫在腹腔镜胆囊癌根治术中的应用
- Author:
Zhongchun XIE
1
;
Bingfu FAN
;
Changwei DOU
;
Jie LIU
;
Jian CHENG
;
Chengwu ZHANG
Author Information
1. 蚌埠医学院研究生院，蚌埠 233030
- Keywords:
Laparoscopy;
Gallbladder cancer;
En-bloc lymphadenectomy;
Prognosis
- From:
Chinese Journal of Hepatobiliary Surgery
2023;29(2):103-107
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the safety and feasibility of en-bloc lymph node dissection in laparoscopic radical resection for gallbladder cancer(GBC).Methods:The clinical data of 87 patients who underwent laparoscopic radical resection for GBC at Zhejiang Provincial People's Hospital from January 2014 to February 2022 were retrospectively analyzed. There were 26 males and 61 females, aged 67.0 (59.0, 72.0) years old. The patients were divided into the en-bloc dissection group ( n=29) and the non-en-bloc dissection group ( n=58) based on whether en-bloc lymph node dissection was carried out. Differences in general data, tumor characteristics, operation, recurrence and survival were compared between the two groups. Postoperative survival status of these patients was followed-up by telephone. Results:The number of lymph nodes dissected in the en-bloc dissection group was 9.0(8.0, 12.0), which was significantly higher than the 8.0(4.8, 11.0) in the non-en-bloc dissection group ( Z=-2.39, P=0.017). There were no significant differences in age, gender, preoperative blood biochemical indexes, tumor carbohydrate antigen 19-9, tumor stage, nerve and vascular invasion, operation time, intraoperative blood loss, postoperative drainage tube retention time, postoperative hospital stay, and incidences of postoperative complications (biliary fistula, abdominal hemorrhage and abdominal infection) between the two groups (all P>0.05). The median survival was longer in the en-bloc group than in the non-en-bloc group (21 vs. 15 months), and the median relapse-free survival time was 18 months in the en-bloc group compared with 10 months in the non-en-bloc group. However, there were no significant differences in postoperative cumulative survival and recurrence-free survival between the two groups (all P>0.05). Conclusion:En-bloc lymphadenectomy was safe and feasible in laparoscopic radical GBC surgery, with more lymph nodes being removed than the non-en-bloc lymphadenectomy group.
