Analysis on clinical efficacy of minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection / 局解手术学杂志

ABSTRACT

Objective To explore the clinical effect of minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection. Methods From September 2010 to September 2012,95 cases of gastric cancer surgically treated from our hospital were selected. Among them,2 cases were converted to laparotomy by abdominal cavity,and a total of 93 patients were included in the study. According to dif-ferent surgical methods,there were 43 cases in the observation group and 50 cases in the control group. The observation group was treated with minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection,and the control group was treated with open surgery combined with D2 lymph node dissection. The bleeding volume,ambulation time,operative time,hospitalization time,lymph node dissection and postoperative complications were compared between the two groups. The recurrence,metastasis and mortality during 1 year,3 years and 5 years follow-up were also compared. Results The bleeding volume in the observation group was less than that in the control group,and the off-bed activity occurred earlier than that in the control group. The hospitalization time was shorter in the observation group than in the control group(P<0. 05),but there was no significant difference in operative time between the two groups(P>0. 05). There was no statistical differ-ence between the number of lymph nodes in the first station, the number of lymph nodes in second stations and the total number of lymph nodes in the two groups(P>0. 05). The incidence of postoperative complications in the observation group(6. 98％) was lower than that of the control group (22. 00％)(P<0. 05). The two groups were followed up for 1,3 and 5 years,and the recurrence rate and mortality rate were low(P>0. 05). Conclusion minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection has significant clinical effect,less blood loss,quicker postoperative recovery and fewer complications,as well as less recurrence and metastasis and death in long-term follow-up.