| BACKGROUND:Laparoscopy-assisted surgery has proved useful in the treatment of early gastric cancer, but its use in advanced cancer has rarely been studied.Objective:To Summarize the clinical data of LADG and investigate the feasibility of laparoscopy-assisted gastrectomy (LAG) versus conventional open gastrectomy (OG) in advanced gastric cancer, and the advantage of laparoscopy-assisted gastrectomy (LAG).Methods:Between January 2010 and December 2010,154 gastric cancer patients underwent LAG, including 22 cases of LAG for early gastric cancer,132 cases of LAG for advanced gastric cancer, in the First Hospital of Jilin University.Summarize the clinical data of 154 cases of LADG, the clinical data of 132 cases of LADG for advanced gastric cancer (110 distal gastrectomy,3 proximal gastrectomy and 19 total gastrectomy) were compared with that of 132 patients who, during the same period, underwent a conventional open radical distal gastrectomy retrospect- tively.Results:In the LAG group,128 operations were completed by laparoscopic technique successfully, Fore laparoscopic gastrectomies were converted to open procedures.Compared to the OG group, the mean operative time in the LAG group was longer [(184.66±35.74)min vs (182.54±35.56)min; P>0.05], but there is no difference between the two teams, the mean blood loss was significantly less [(160.00±102.06)ml vs (277.58±122.13)ml; P＜0.05]; the mean length of incision was significantly shorter [(5.58±1.79)ml vs (21.28±2.15)ml; P＜0.05], no signifycantly difference was observed for the mean number of harvested lymph node,the mean length of proximal and distal margin to the tumor [(33.83±13.80) vs (35.17±13.64); P >0.05], [(5.91±0.41)cm vs (5.99±0.51)cm; P>0.05] [(6.01±0.49)cm vs (5.97±0.50)cm; P >0.05], the mean times of analgetic injection was significantly less [(1.64±0.77) vs (3.74±0.98); P<0.05], firis flatus time was shorter [(3.51±0.66)d vs (4.08±0.89)d; P<0.05], hospital stay was shorter [(8.33±3.38)d vs (9.50±3.46)d; P<0.05], the LAG group has lower complication rate (9.09% vs 22.73%). Refering to the lymphadenectomy of No.10, No.11, no signifycantly difference was observed for the mean number of harvested lymph node, the hemorrhage rate and spleen resection rate.Compare to the pathology diagnosis, CT has an accurate TNM stagin (76.7%), and an accurate operation resection rate (98.1%) to Laparoscopy-assisted radical gastrectomy cases.There are five laparoscopy-assisted extended radical gastrectomy cases, the mean operative time was 220 minute, the mean blood loss was 260ml, no complication.Conclusion:Laparoscopy-assisted radical gastrectomy for advanced gastric cancer with D2 lymphadenectomy is a safe, feasible procedure, which has the same cancer clearance as open surgery, and the advantages of less invasive surgery trauma,less pain, quick postoperative recovery, lower complication rate. As open surgery, Laparoscopy-assisted radical gastrectomy has the same effet, refering to the lymphadenectomy of No.10, No.11. As an important part of standard diagnosis to carcinoma of stomach, CT has an accurate TNM stage to advanced gastric carcinoma, and guide the laparoscopy-assisted radical gastrectomy. Laparoscopy-assisted extended radical gastrectomy is a safe, feasible procedure.that based on the premise that we have well evaluation.
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