The Clinical Study On The Application Of Laparoscopic D2Radical Resection For Advanced Gastric Cancer

The purpose of this study on the application of laparoscopic D2radical resection for advanced gastric cancer and open radical resection in curing gastric cancer is to further evaluate the safety and feasibility of the technique of laparoscopic D2radical resection.Methods A retrospective analysis on the129cases of advanced gastric cancer surgery conducted from January,2010to December,2010shows that among the129cases, there are totally58cases being fully treated by the laparoscopic D2radical resection, including circulating and removing the tumour cells and cleaning the lymph nodes of the stomach, then a small incision of the epigastric hernia helps the removing the speciman and the reconstruction of the digestive tract. Compared with the71cases by open radical resection, the observation indicators include operative time, blood loss, number of lymph node dissection, postoperative passage of flatus, postoperative consumption of time, postoperative hospital stay, postoperative complications, as well as the survival and recurrence of two groups of patients after operation.Results All58patients of the laparoscopic group were cured by laparoscopic D2radical resection without any transfer. The average operative time in laparoscopic group was166.7±43.8min, open group (160.16±40.8min), a difference of no significant; intraoperative blood loss was124.2±144.7ml and206.7±217.5ml respectively, the laparoscopic group was significantly less than open group (P<0.05). Anal exhaust time was (1～5) d and (8) d respectively, the laparoscopic group was significantly shorter than the open group (P<0.01). The postoperative complications were limited to10.3%, lower than the open group (24.3%), but the difference was not significant. The two groups both had no surgical deaths. The average number of lymph node dissection of laparoscopic group was22.8±4.0, while the open group was (26.8±7.0); the average distances between the gastric stumps and the tumour were2.6cm4.6±and4.6±1.8cm, with no significant difference of open group (5.3±3.1cm and3.9±2.0cm), no residual invasive cancer in both groups. The median follow-up17(2-38months after surgery) shows that in the laparoscopic group,6patients died, while9patients of the open group died. Conclusion The laparoscopic D2radical resection for advanced gastric cancer has been feasible and safe with a satisfactory result recently. Compared with open gastric cancer, D2radical resection is advanced in smaller surgical trauma, earlier postoperative recovery of gastrointestinal function, earlier eating, etc., with a significant decreasing postoperative complication. It has a similar radical effect with open radical resection. However, the long-term effect of this technique remains to be further studied.