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Laparoscopic versus open surgery for D2 gastrectomy in advanced gastric cancer

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Author:
No author available
Journal Title:
Chinese Journal of Gastrointestinal Surgery
Issue:
9
DOI:
10.3760/cma.j.issn.1671-0274.2012.09.025
Key Word:
胃肿瘤;胃切除术;腹腔镜;预后;Stomach neoplasms;Gastrectomy;Laparoscopy;Prognosis

Abstract: Objective To investigate the safety and feasibility of laparoscopic D2 gastrectomy for advanced gastric cancer.Methods The clinical data of 210 cases of laparoscopic gastrectomy and 180 cases of open gastrectomy for radical (D2) gastrectomy from May 2007 to Dec 2010 were analyzed retrospectively.Results A total of 206 cases underwent laparoscopic-assisted surgery with 4 conversions.Compared to the open group,the laparoscopic group was associated with less bleeding [ (208±38) ml vs.(300±52) ml,P<0.05],quicker postoperative recoverv of bowel function[ (2.9±0.7) d vs.(3.9±1.8) d,P<0.05],shorter postoperative length of hospital stay[(12.8±6.2) d vs.(15.6±6.8) d,P<0.05],longer operative time [(258±42) min vs.(193±30) min,P<0.05].The number of lymph node harvested was 20.5±1.9 in the laparoscopic group and 25.8±1.5 in the open group,and the postoperative complication rate was 8.1% (17/201) vs.8.5% (15/180),and differences were not statistically significant (both P>0.05).The recurrence rate was 2.9%(6/210) and 2.8%(5/180),and the 3-year overall survival rate was 35.6% and 37.8%,the differences were not statistically significant (both P>0.05).Conclusions Laparoscopic radical gastrectomy for gastric cancer is safe and effective,which can reach the same range of lymph node dissection as open gastric cancer surgery and similar survival rate.

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