Liangang Ma, Dr, Hongqing Xi, Dr, Lin Chen, Dr. Chinese People’s Liberation Army General Hospital.
INTRODUCTION: To investigate the efficacy and advantages of laparoscopy-assisted radical gastrectomy (LAG) with D2 dissection of lymph nodes versus conventional open D2 gastrectomy (OG) in advanced gastric cancer.
METHODS AND PROCEDURES: One hundred and twenty patients with advanced gastric cancer were operated on from February 2011 to April 2012, of which 61 patients with laparoscopy-assisted radical gastrectomy (LAG group) while 59 with conventional open D2 gastrectomy (OG group). Clinical data both of the two groups were analysised Following the patients once a month until July 2013 and recorded the ending of them.
RESULTS: Compared with OG group, LAG group turned out to shorter incision lengths (17±3)cm vs (8±2.5)cm, operative time (258±45)min vs (305±50)min, post-operation hospital stays(15±4)d vs (9±2)d, recovery time of bowel activity (7±2)d vs (4±2)d and more intro-operative bleeding volume (350±200)ml vs (160±85)ml, of which differences were significant (P<0.05). The number of lymph nodes of the OG group and LAG group was similar (38±15) vs (34±14), and the difference was no significant (P>0.05). There were no post-operative complication happened in the OG group, while two in LAG group and one of whom was gastroparesis and another was abdominal infection. The mean follow-up time of LAG group was (14.8±6.0) months, and OG group was found (15.7±5.5) months. Five cases missed in LAG group and four missed in OG group. The differences of follow-up time and non-investigation rate between the two groups were no significant (P>0.05). The individual rate of recurrence, metastasis and mortality of the LAG group and OG group were 5.4%(3/56) vs 3.7%(2/54), 7.1% (4/56) vs 7.4%(4/54) and 12.5%(7/56) vs 11.1%(6/54), of which the differences were no significant (P>0.05).
CONCLUSIONS: Compared with conventional open D2 gastrectomy, the laparoscopy-assisted radical gastrectomy is safe and technically feasible with shorter incision, less bleeding volume and better post-operative recovery while there are no significant differences in radical degrees. And the rate of recurrence, metastasis and mortality are not remarkable increase in a short period.