Effects of laparoscope assisted total gastrectomy and open gastrectomy combined with D2 dissection in the treatment of upper gastric cancer and the impact on stress response / 中国内镜杂志

ABSTRACT

Objective?To investigate the effects of laparoscope assisted total gastrectomy (LATG) and open total gastrectomy (OTG) combined with D2 dissection in the treatment of upper gastric cancer and the impact on stress response.?Methods?145 patients with upper gastric cancer who underwent total gastrectomy from June 2014 to June 2017 were selected as research subjects, and they were divided into study group (treated by LATG, n = 70) and control group (treated by OTG + D2 dissection, n = 75) according to different surgical methods. The general condition of surgery, stress indexes cortisol (Cor), C reactive protein (CRP), postoperative recovery and the incidence of complications were compared between the two groups.?Results?The surgical time of the study group was longer than that of the control group, while the length of incision, intraoperative blood loss and length of hospital stay were shorter/less than those of the control group (P < 0.05). There was no significant difference in the number of dissected lymph nodes between the two groups (P > 0.05). Serum Cor and CRP levels in the study group were lower than those the control group during surgery and at 3 d after surgery (P < 0.05). The initial exhaust time and recovery time of liquid diet in the study group was shorter than that in the control group (P < 0.05), but there was no significant difference between the two groups in the rate of second surgery and readmission rate within 30 days (P > 0.05). The incidence of complications in the study group at 6 months after surgery was lower than that in the control group (P < 0.05).?Conclusion?Compared with OTG and D2 dissection, LATG has advantages of less trauma, earlier exhaust and feeding and fewer stress reactions, with quick recovery and few complications.