A Retrospective Comparison Of Laparoscopic Radical Gastrectomy With Open Surgery And An Investigation Into Its Oncological Safty

Background and purpose: The microinvasiveness of laparoscopic surgery has prompted the exploration of its use in nearly every fields of abdominal surgery. Although the use of laparoscopic technique in malignant neoplasms has been hotly debated over the last decade due to concerns over its effectiveness in lymphadenectomy, reported higher rate of port site rucurrence and the possible side effect it might have on peritoneal metastasis. Several prospective randomised trials comparing laparoscopically asisted and open surgery for curable colon and rectal cancer have provided substantial evidence that laparoscopic surgery for colorectal cancer produces the same longterm survival rate as open surgery. Laparoscopic radical surgery for gastric cancer, however, has developed slowly as compared with laparoscopic colorectal surgery due to the complicated anatomy and the complexity of D2 lymphadenectomy which is cosidered mandatory by Asian surgeons for the cure of most gastric cancers. So far, most cases of laparoscopic gastrectomy for gastric cancer are associated with a D1+αor D1+βlymphadenectomy reportedly. There are only few reports on laparoscopic D2 lymphadenectomy with limitted cases.This paper is to investigate the feasibility, safety and cancer clearance of laparoscopy-assisted gastrectomy with D2 lymphadenectomy for early gastric cancer as well as some advanced gastric cancer. With comparison to the result of open surgery, the short-term follow up result of laparoscopic gastric surgery will also be provided. The effect of laparoscopic gastrectomy on postoperative qulity of life is also investigated. Peritoneal carcinomatosis is the first cause of death for patients after radical gastrectomy. To investigate the impact of laparoscopic surgery on peritoneal dissemination, we investigated the existence of aerosolization of tumor cells in an in vitro model and the effect of CO2 peritoneum might have on peritoneal carcinomatosis in an in vivo model.Pathoclinical data and methods: 1. Among 121, patients117 procedures of laparoscopic radical gastrectomy had been completed successfully, with a conversion rate of 3.31% (4 cases). Laparoscopic D1 + 7 lymph nodes dissection was accompanied with these...