Clinical value of three-dimensional laparoscopic radical gastrectomy for gastric cancer / 中华消化外科杂志

ABSTRACT

Objective To investigate the clinical value of three-dimensional (3D) laparoscopic radical gastrectomy for gastric cancer.Methods The retrospective and descriptive study was adopted.The clinical data of 28 patients who underwent 3D laparoscopic radical gastrectomy for gastric cancer at the First Affiliated Hospital of Nanjing Medical University from October 2014 to March 2016 were collected.Trocar placement and surgical procedures were the same as 2D laparoscopic radical gastrectomy.Observation indicators included (1) surgical situationsoperation time,volume of intraoperative blood loss,number of lymph node dissected,(2) postoperative situationstime for out-of-bed activity,time to anal exsufflation,time for fluid diet intake,occurrence of complications and duration of hospital stay,(3) follow-up situations.The follow-up was performed to detect postoperative survival of patients and tumor recurrence and metastasis by outpatient examination and telephone interview up to May 1st,2016.Measurement data with normal distribution were presented as x ± s.Results (1) Surgical situationsall the 28 patients underwent successful 3D laparoscopic radical gastrectomy,without conversion to open surgery and perioperative death.Seven patients received 3D laparoscopy assisted total gastrectomy with Roux-en-Y esophagojejunostomy,with operation time of (214 ± 47)minutes.Twenty-one patients underwent 3D laparoscopic distal gastrectomy with uncut Roux-en-Y gastrojejunostomy,with operation time of (181 ± 27) minutes.Volume of intraoperative blood loss and number of lymph node dissected in 28 patients were (53 ± 29)mL and 34 ± 10.(2) Postoperative situationstime for out-of-bed activity,time to anal exsufflation and time for fluid diet intake were (54 ± 17) hours,(77 ± 16) hours and (5.0 ± 1.1) days,respectively.Of 28 patients,1 complicated with gastrointestinal hemorrhage was cured by conservative treatment,and other patients had no complications.Duration of postoperative hospital stay was (8.8 ± 1.6) days.(3) Follow-up situationsall the 28 patients were followed up for 2-18 months with a median time of 10 months,without occurrence of tumor recurrence and metastasis.One patient undergoing 3D laparoscopic distal gastrectomy with uncut Roux-en-Y gastrojejunostomy was complicated with afferent recanalization,without obvious discomfort,and received regular gastroscopy reexaminations to detect bile reflux.Conclusion 3D laparoscopic radical gastrectomy for gastric cancer is safe and feasible,with good short-term outcomes.