Clinical Research Of Short-term Efficacy Of Siewert Ⅱ/ⅢType Adenocarcinoma Of Gastroesophageal Junction Underwent Open And Laparoscopic Radical Total Gastrectomy

ObjectiveTo compare the short-term efficacy between open and laparoscopic radical gastrectomy in patients with SiewertⅡ/Ⅲtype gastroesophageal junction adenocarcinoma.MethodsFrom Jan 2012 to Dec 2013, according to the selected criteria, a total of 253 patients with SiewertⅡ/Ⅲtype gastroesophageal junction adenocarcinoma(AEG) including 212 cases who received open radical total gastrectomy (OTG) and 41 cases who received laparoscopic radical total gastrectomy (LTG) were collected from Gastrointestinal Surgery Ward Ⅰ Department and General Surgery Ward Ⅷ Department in the First Affiliated Hospital of Anhui Medical University. These patients were underwent radical gastrectomy with Roux-en-Y bypass. The Clinical indicators, nutrition indicators and postoperative short-term efficacy in two groups were analysed.Results1. Comparison results of clinical stage Ⅰ/Ⅱ.The operative time in the open group was 146.33±49.55 min which was significantly differently from 277.29±55.64 min in the laparoscopy group(P<0.05). The time to eat liquid in the open group was 6.58±1.71 d which was not significantly differently from 7.86±3.43d in the laparoscopy group(P>0.05). The duration of postoperative hospital stay in the open group 12.29±5.35 d which was not significantly differently from 17.4±17.96 d in the laparoscopy group(P>0.05). The number of lymph nodes in the open group was 13.86 ±6.02 which was not significantly differently from 14.19±8.16 in the laparoscopy group(P>0.05). The number of positive lymph nodes in the open group was 0.14 ± 0.66 which was not significantly differently from 0.38 ± 1.16 in the laparoscopy group(P>0.05). The prognostic index, preoperative and postoperative lymphocyte count, albumin, prealbumin and hemoglobin in the open group was not significantly differently from the laparoscopy group(P>0.05),respectively.2. Comparison results of clinical stage Ⅲ The operative time in the open group was 158.24±53.55 min which was significantly differently from 301.10±83.33 min in the laparoscopy group(P<0.05). The time to eat liquid in the open group was 6.44± 1.56 d which was not significantly differently from 7.00±3.14d in the laparoscopy group(P＞0.05). The duration of postoperative hospital stay in the open group 11.30±3.64 d which was not significantly differently from 12.35±4.34 d in the laparoscopy group(P>0.05). The number of lymph nodes in the open group was 18.72 ± 7.33 which was not significantly differently from 17.80±6.16 in the laparoscopy group(P>0.05). The number of positive lymph nodes in the open group was 6.14±4.86 which was not significantly differently from 6.10±6.22 in the laparoscopy group(P>0.05). The prognostic index, preoperative and postoperative lymphocyte count, albumin, prealbumin and hemoglobin in the open group was not significantly differently from the laparoscopy group(P>0.05),respectively.ConclusionsDue to comparison results of prognostic index, postoperative albumin, prealbumin and hemoglobin,the time to eat liquid and the duration of postoperative hospital stay in the open group with the laparoscopy group of clinical stage Ⅰ/Ⅱ and Ⅲ (P>0.05). In the early learning curve, compared to open surgery, the laparoscopy radical total gastrectomy with Roux-en-Y bypass in SiewertⅡ/Ⅲtype AEG patients did not show a superiority in short-term effect.