| Objective: To compare the perioperative and postoperative data of two groups treated with LARG(laparoscopy-assisted radical gastrectomy)and ORG(open radical gastrectomy)in order to investigate the safety and clinical effects of laparoscopic assisted radical gastrectomy.Methods: A total of 328 patients with advanced gastric cancer who went through surgeries from August 2015 to December 2017 in Department of General surgery,Nanjing First Hospital,including 131 patients in LARG group and 197 patients in ORG group,were included in our research.The preoperative general information(gender,age,body mass index BMI,preoperative complications,American Society of anesthesiologists grade),tumor pathological characteristics(gastric tumor location,diameter,T.N stage,pathological stage),intraoperative information(operation time,blood loss,incision length,distance between upper/lower incisions and tumor,digestive tract reconstruction method,number of lymph nodes removed during operation),postoperative data(postoperative exhaust time,postoperative hospital stay,postoperative inflammatory indicators,postoperative complications,etc.)and 3-year survival rate were compared.In order to reduce the variables,the selected cases were performed by experienced surgeons of the same group.Results: All the operations were successfully completed.(1)There was no significant difference in basic data(gender,age,body mass index,preoperative complications,ASA grade)and tumor pathological data(tumor location,diameter,T/N stage,pathological stage)between the two groups(P > 0.05).(2)The average operation time was 220.8 ± 45.8 minutes in LARG group and 175.1 ± 62.1 minutes in open radical gastrectomy group(P < 0.05).The incision length of laparoscopic gastrectomy group was shorter than that of open gastrectomy group(P < 0.05),so the difference was statistically significant.The intraoperative blood loss in LARG group was significantly less than that in ORG group(133.0 ± 153.2 vs 208.3 ± 110.6,P <0.05).However,there was no significant difference in the number of lymph nodes that removed and the distance between the tumor and the upper/lower incisions between the two groups.(3)The first exhaust time of LARG group was 2.8 ± 0.8days,which was significantly shorter than that of ORG group(3.5 ± 1.1 days,P <0.05).The laparoscopic group was also better than the open operation group in the time of gastric tube removal,postoperative hospital stay and postoperative inflammatory indexes(P < 0.05),which showed the advantages of LARG group in postoperative recovery.However,there was no significant difference in the incidence of postoperative complications and 3-year survival rate between the two groups(P >0.05).Conclusion: Laparoscopy-assisted radical gastrectomy(LARG)is safe and feasible.Compared with open radical gastrectomy(ORG),although the incidence of postoperative complications and long-term clinical effect are similar,LARG has the advantages of faster recovery of gastrointestinal function,less trauma,less postoperative inflammatory reaction and shorter hospital stay. |
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