Comparison of laparoscopy-assisted gastrectomy versus open gastrectomy with D2 lymphadenectomy in the treatment of advanced gastric cancer / 中国综合临床

ABSTRACT

Objective To investigate the safety and efficacy of laparoscopy-assisted D2 radical gastrectomy in the treatment of advanced gastric cancer.Methods From March 2011 to March 2016,one hundred and four cases treated with LAG for advanced gastric cancer in the general surgery department of Gaochun District People Hospital of Nanjing and the 251st Hospital of PLA were collected in the laparoscope group,104)and 101 cases undergoing gastric cancer surgery from the same period were selected as the control group(open surgery group).A retrospective analysis was performed between the two groups in operation time, intraoperative blood loss, postoperative eating time, ambulation time, exhaust time, postoperative fever, postoperative analgesic use,hospitalization time,postoperative complications,the proximal and distal margins and the number of lymph node dissection.Results The operation time was significantly longer in the LAG group than in the open surgery group(311.2 ± 28.9)min vs.(157.38 ± 11.9)min,t=2.899,P<0.01).The intraoperative blood loss in the laparoscope group was less than that in the open surgery group((100.3±12.1) ml vs.(200.6±16.3)ml,t=3.014,P<0.01).In addition,the frequency of postoperative analgesia,the first postoperative exhaust time,the first postoperative eating time and the postoperative hospital stay in the laparoscopic group were better than those in the open surgery group(P<0.05).There was no significant difference in the number of lymph node dissection and postoperative complication between the two groups(P=0.264,P=0.575).The survival analysis showed that the overall survival rate in the two groups was equivalent at 6 years after surgery(P=0.623).Conclusion Laparoscopy-assisted radical gastrectomy for advanced gastric cancer is safe and feasible,with acceptable long-term results,and shows better performance in the near future.