Clinical efficacy and safety of 1aparoscopy-assisted distal gastrectomy for gastric cancer / 中国内镜杂志

ABSTRACT

Objective To evaluate the clinical efficacy and safety of 1aparoscopy-assisted distal gastrectomy (LADG) for patients with advanced gastric cancer. Methods Clinical data of 198 cases with advanced gastric cancer were retrospectively analyzed. Based on the surgical approach, patients were divided into laparotomy group (n = 101) and laparoscopic group (n = 97), and the intraoperative situation, postoperative complications and quality of life were compared. Results There were no statistical differences in operation time [(226.30 ± 36.40) vs (220.50 ± 29.90) min, t = 1.23, P = 0.221)], number of lymph node cleaning [(22.01 ± 4.99) vs (20.69 ± 4.53), t = 1.95, P = 0.053] between the two groups; the blood loss of laparoscopy group was less than the laparotomy group [(114.50 ± 20.30) vs (168.30 ± 40.04) ml, t = 11.77, P = 0.000]; gastrointestinal function recovery time of laparoscopy group was less than laparotomy group [(72.30 ± 7.91) vs (84.05 ± 9.04) h, t = 9.72, P = 0.000); hospital stay of laparoscopy group was less than the laparotomy group [(8.89 ± 1.57) vs (10.36 ± 2.65) d, t = 4.72, P = 0.000]; there were no statistical differences in the tumor proximal cut end [(5.07 ± 2.04) vs (4.85 ± 1.98) cm, t = 0.77, P = 0.442) and margin of distal [(4.33 ± 1.90) vs (3.90 ± 2.02) cm, t = 1.54, P = 0.125] between the two groups; the postoperative complication rate of laparoscopy group and laparotomy group was 9.27% (9 cases ) and 7.92% (8 cases), respectively, the differencewas not statistically significance (χ2=0.01, P = 0.907); KPS score of laparoscopy group in 7 days after surgery were higher than laparotomy group [(79.33 ± 15.54) vs (73.49 ± 13.37), t = 2.84, P = 0.005], and in 30 days after surgery showed no statistical differences. Conclusion The clinical effect of 1aparoscopy-assisted distal gastrectomy for advanced gastric cancer is equivalent to the laparotomy, while with less trauma. Short-term quality of life in 1aparoscopy group is higher than laparotomy group.