ABSTRACT
Objective To evaluate laparoscopic D2 lymph node dissection gastrectomy in the treatment of advanced gastric cancer.Methods The clinical data of 239 cases of advanced gastric cancer admitted from January 2004 to June 2011 were respectively analyzed,patients were divided into laparoscopic resection group and open surgery group.Data analysis was performed by SPSS 19.0 statistical software.Results There were 102 cases in laparoscopic group,and 137 cases in open group.The length of incision,operative blood loss,recovery time of gastrointestinal function,food-taking time and postoperative hospital stay in laparoscopic operation group were (5.0 ± 1.1) cm,(70 ± 44) ml,(57 ± 14) h,(68 ± 12) h,(7.1 ± 1.4) d and in open operation group were (17.4 ± 2.1) cm,(107 ± 59) ml,(75 ± 12) h,(91 ±15) h,(9.9 ± 1.8) d respectively.There were significant differences between the two groups (t =-58.86,-5.50,-10.72,-12.58,-12.58,all P =0.00).There was no significant differences between the two groups in operative time (t =1.63,P =0.11),with operative time in laparoscopic operation group of (192 ± 32) min,and (185 ± 30) min in open group.Average proximal,distal cutting edge and the average number of lymph node harvested were (5.0 ± 1.0) cm,(4.7 ± 0.8) cm,(27.6 ± 7.2) in laparoscopic operation group,and (5.1 ±0.9) cm,(4.7 ±0.9) cm,(27.0 ±6.5) in open group (t =-0.61,0.10,0.68,P ＞ 0.05).The 3-,5-,7 d white blood cell counts in laparoscopic group was (11.1 ± 1.3) ×109/L,(9.5 ± 1.4) × 109/L,(7.0 ± 1.5) × 109/L,and (12.8 ± 1.3) × 109/L,(11.1 ± 1.5) × 109/L,(8.6 ± 1.3) × 109/L,in open group (t =-9.83,-8.88,-9.40,all P =0.00).Complications developed in 9.8 ％ (10/102) in laparoscopic operation group,and 17.5 ％ (24/137) in open group (x2 =0.285,P =0.09).The 1-year,3-year,5-year survival rate of patients in laparoscopic group were 96.1％,74.1％,47.2％,and 95.6％,70.0％,50.9％ in open group (x2=0,0.04,0.21,P ＞0.05).Conclusions In selected cases,laparoscopic D2 lymph node dissection gastrectomy for advanced gastric cancer is safe and effective,and long-term outcomes are satisfactory.