Impact of operative time on patients undergoing laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the effect of operative time on laparoscopy-assisted distal gastrectomy (LADG) with D2 lymph node dissection and the influencing factors of operative time.</p><p><b>METHODS</b>Clinical data of 332 patients with gastric cancer undergoing LADG with D2 lymph node dissection from January 2007 to December 2010 were analyzed retrospectively. The average operative time was (205±56) minutes. Operative indices and postoperative recovery were compared between patients with operative time≥205 min (long-time group) and operative time<205 min (short-time group).</p><p><b>RESULTS</b>The mean blood loss [(81.0±65.7) ml vs. (65.8±55.0) ml], time to ambulation [(3.1±1.7) d vs. (2.3±1.2) d], time to first flatus [(3.8±1.1) d vs. (3.2±1.3) d], postoperative hospital stay [(14.2±6.3) d vs. (12.5±7.0) d], and postoperative complication [16.0% (19/119) vs. 8.5% (18/213)] between long-time group and short-time group were significantly different (all P<0.05), while there were no significant differences in transfused patients, time to resume soft diet, and mortality (all P>0.05). Multivariate logistic regression analysis revealed that BMI (P<0.01), lymph node metastasis (P<0.05), and surgeon experience (P<0.01) were independent risk factors for operation time.</p><p><b>CONCLUSION</b>Surgeons who have limited experience in LADG with D2 lymph node dissection should operate on patients with low BMI and less lymph node metastasis in order to reduce postoperative complications.</p>