A comparative study of laparoscopic-assisted and open distal gastrectomy for advanced gastric cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety, feasibility and the long-term outcomes of laparoscopy-assisted gastrectomy (LAG) for advanced gastric cancer (AGC).</p><p><b>METHODS</b>The clinical and follow-up data of 46 cases after LAG from June 2008 to December 2009 were analyzed, and compared with 85 cases after conventional open gastrectomy (OG) for advanced gastric cancer at the same period at our hospital. The surgical safety, postoperative recovery, complications, radical degree, survival rate were compared.</p><p><b>RESULT</b>As compared with OG group, operation time was longer in LATG group ((274 ± 78) min vs. ( 217 ± 41) min, t = 4.635, P = 0.000). Estimated blood loss in the LAG group ((254 ± 112) ml) was significantly less than in the OG group (t = 3.942, P = 0.000). Time to ambulation ((63 ± 16) hours), first flatus ((77 ± 20) hours), resumed liquid diet ((88 ± 15) hours), duration of analgesic medication ((53 ± 20) hours) and postoperative hospital stay ((11.1 ± 4.6) days) were significantly shorter in the LAG group (t = 5.549, 6.508, 9.436, 9.464 and 2.980 respectively, all P < 0.01). The distance of the proximal and distal resection margin were (5.7 ± 1.4) cm and (3.9 ± 1.5) cm in LAG group, (5.8 ± 1.1) cm and (4.7 ± 1.5) cm in OG group respectively, but the difference was not significant. The number of lymph node dissections was also similar, (30.5 ± 10.4) in LAG group and (32.6 ± 12.3) in OG group (t = 0.960, P = 0.339). The incidence of postoperative complications and mortality rate in LAG group (8.7% and 0 respectively) were also lower than in the OG group, with no statistically significant difference (P > 0.05). The mean follow-up was 31.0 months (range 6-48 months), and the cumulative survival of the 2 groups was similar (χ(2) = 1.594, P = 0.207).</p><p><b>CONCLUSIONS</b>Laparoscopy-assisted gastrectomy for advanced gastric cancer is not significantly different with open surgery in surgical safety, radical degree, and survival rate. It is less traumatic and of fewer complications.</p>

Clinical analysis of the CD_(117)-weak and CD_(117)-negative gastrointestinal stromal tumors:a report of 13 cases / 肿瘤研究与临床

Objective To explore the CT features in CD_(117)-weak and CD_(117)-negative gastrointestinal stromal tumors(GIST).Methods The CD_(117)-weak and CD_(117)-negative Gist proved by pathologically and sur- gically in 13 cases were retrospectively analyzed.Results The tumor was located in the stomach in 6 cases, small intestine in 4 cases,colorectum in 2 cases,greater omentum in one case.The most common clinical manifestations were abdominal pain or discomfort in 6 cases,hematemesis or melena in 3 cases.Malignant tu- mors occurred in 8 cases.Benign tumors occurred in 5 cases.A soft tissue was identified in all 13 cases in CT examination.The CT examinations revealed cystic regions and bleeding in 5 cases.Calcification was not noted within the masses in all cases.The mean diameter of benign tumors was 3.4 cm?2.8 cm while that of malig- nant tumor was 7.5 cm?6.2 cm.All the cases underwent operation,the resection rate was 100%.After follow up from 6 months to 4 years in 10 cases,1 case died of tumor recurrence and metastasis,the others survived. Conclusion CD_(117)-weak and CD_(117)-negative Gist occurred more common in the stomach.CT is useful in lo- cation and differentiation of CD_(117)-weak and CD_(117)-negative gastric stromal tumors with regard to benign or malignant.Surgery is the main method for final diagnosis and treatment.