| Objectives:Gastric cancer is the second most common malignancy in the world, second only to lung cancer. The annual neopathy of gastric cancer in China is about400,000, accounting for42%of the world. The mortality rate of gastric cancer is about23.02%of all malignancies, ranking at the first place of the various types cancer. The most effective treatment of gastric cancer is surgery. The method of surgery is open gastrectomy technology which is relatively mature and conventional treatment. However, with the current advances in technology, minimally invasive surgery has become the development trend. Recent years, china has a great progress in this area, but not yet extensive. This study was concern in laparoscopic-assisted gastric cancer radical surgery comparing with open gastric cancer surgery in the feasibility of minimally invasive and postoperative differences in efficacy.Methods:This study selected30cases laparoscopic gastrectomy in the Second Department of General Surgery of the Second Affiliated Hospital of Dalian Medical University from June2011to December and35cases open gastric cancer surgery as the control group. We compared the surgery method, operative time, intraoperative blood loss, lymph node dissection, the number of tumor resection margin distance after exhaust time, meal time, incision length, postoperative hospital stay and postoperative complications.Results:Laparoscopic group average intraoperative blood loss was205.3ml, the open surgery group average intraoperative blood loss was397.4ml. Intraoperative blood loss of laparoscopic group was less than the control group. The difference show a statistical significance (P<0.05). The length of the incision in laparoscopic group average at5.4cm, while the laparotomy group average at16.5ml. The difference show a statistical significance (P<0.05). Laparoscopic group, with an average postoperative exhaust time for three days, the average feeding time for the first time to3.2days, the mean postoperative hospital stays were7.7days. And the average postoperative passage of flatus in the laparotomy group was4.1days, with an average feeding time for the first time4.3days, the mean postoperative hospital stays were8.9days. The difference show a statistical significance (P<0.05). The complication rate was not significant difference in two groups (P>0.05). The average numbers of lymph node dissection were16.67in the laparoscopic group, the laparotomy group average at17.08. The difference was not statistical difference (P>0.05). The median length of proximal and distal resection margin in the laparoscopic group was5.3cm, laparotomy group was5.4cm, and the difference was not statistical difference (P>0.05). Laparoscopic group, the average operative time was4.7hours, the laparotomy group was3.6hours. The difference show a statistical significance (P<0.05).Conclusion:During the comparing of laparoscopic-assisted gastric cancer with radical surgery versus open gastric cancer, this study showed that laparoscopic gastrectomy has less blood loss, shorter postoperative exhaust time, shorter eating time and shorter length of the incision. The lymph node dissection the numbers and the distance of the tumor resection margin in two groups were no significant difference. The advantage in laparoscopic gastrectomy is more obvious. The operative time in laparoscopic gastrectomy was longer than the control. We believe that it would be improved with enough skill practices. Therefore, we believe that laparoscopic-assisted radical resection of gastric cancer is safe and feasible. It is reliable to achieve the same tumor radical resction as the open gastric cancer surgery. And the laparoscopic-assisted radical resection of gastric cancer showed more minimally invasive advantages than open surgery. |
PDF Full Text Request