Clinical Research Of Laparoscopy-assisted Total Gastrectomy For Advanced Gastric Cancer

Objectives:To evaluate the feasibility and safety of the laparoscopy-assisted total gastrectomy in the treatment of advanced gastric cancer in comparison to open total gastrectomy.Methods:From July 2013 to January 2015, a total of 170 cases with advanced gastric cancer were non-randomly divided into two groups:65 cases underwent laparoscopy-assisted total gastrectomy and 105 cases underwent open total gastrectomy. Basic data, pathological characteristics, perioperative clinical results, postoperative complications were analyzed.Results:No significant differences were found in the laparoscopy-assisted total gastrectomy group compared with the open total gastrectomy group in terms of the number of lymph node dissected. Compared with open total gastrectomy, laparoscopy-assisted total gastrectomy has shorter postoperative hospital stay, shorter time to flatus, shorter time to soft diet, less intraoperative blood loss, lower rate of postoperative complication, lower pain score. However, laparoscopy-assisted total gastrectomy needs longer time of operation.Conclusion:Laparoscopy-assisted total gastrectomy has similar degree of lymph node dissected as open total gastrectomy. Laparoscopy-assisted total gastrectomy has the advantages of being less invasive, faster recovery, and lower rates of postoperative complications.Objective:To systematically evaluate the safety and degree of lymph node dissection of laparoscopy-assisted total gastrectomy for advanced gastric cancer.Methods:The literatures were searched from CENTRAL、Medline (Pubmed)、Embase、 Chinese Biological Medical Datebase、Chinese National Knowledge Infrastructure、Wanfang Database. All randomized controlled trials and non-randomized controlled study comparing laparoscopy-assisted total gastrectomy and open total gastrectomy for advanced gastric cancer were collected. Data collection from January 1994 to March 2014. RevMan5.2 software was used for Meta-analysis.Results:We collected six studies including 1,115 patients (547 patients underwent laparoscopy-assisted total gastrectomy, and 568 patients underwent open total gastrectomy). Compared with open total gastrectomy, laparoscopy-assisted total gastrectomy has fewer complications, less intraoperative blood loss, shorter postoperative hospital stay, but, a longer time of operation. There were no significant differences in the numbers of lymph node dissected between two groups.Conclusion:Laparoscopy-assisted total gastrectomy is superior to open total gastrectomy for advanced gastric cancer.