The Comparative Study Of Laparoscopy-assisted And Open Surgery On Radical Gastrectomy With D2Dissection For Advanced Gastric Cancer

Objective:To explore the feasibility and clinical effectiveness of LA+D2(laparoscopy-assistedsurgery on radical gastrectomy with D2dissection for advanced gastric cancer) by acomparative study of LA+D2and OA+D2(open surgery on radical gastrectomy with D2dissection for advanced gastric cancer).Methods:We reviewed the clinical materials of80patients who underwent LA+D2and120patients who underwent OA+D2in Affiliated Hospital, Yan’an University from January2008to January2012. Of them,99patients received radical dissection of distalgastrectomy,47of proximal gastrectomy and54of whole stomach. Between-groupcomparison included their clinical status, pathological condition, recovery from surgery,incidence of postoperative complications and survival rate.ResultsAll patients completed their surgeries smoothly. Difference between groups in the lymphnodes dissection was not statistically significant (P>0.05). The mean procedure time ofLA+D2group was sinificantly less than that of OA+D2group. LA+D2group wasgreatly superior to OA+D2group in terms of postoperative exhaust time, eating time andhospital admission. Both groups had a1-year survival rate of100%, with no significantdifferences in2and3-year survival rate (P>0.05). Fourteen (17.50%) of80patients inLA+D2group had complications, as did eighteen15.00%) in OA+D2group; none required further surgical treatment during their hospital admission. Recurrence rate ofcomplications did not differ significantly between groups (P>0.05).Conclusions:1. It is feasible to clear the lymph nodes using LA+D2, in addition, LA+D2can achieve asimilar effect as traditional OA+D2. That is in accord with contemporary principlesof cancer treatment.2. LA+D2has the advantages of minimal invasion, rapid recovery and safety, comparedwith traditional OA+D2.3. LA+D2has a similar short-term effectiveness as traditional OA+D2, and difference in3-year survival rate is not statistically significant. Further follow-up andobservations are still needed to investigate long-term clinical effectiveness ofLA+D2.