The Influence Of Neoadjuvant Chemotherapy Prior On Patients With Laparoscopic Radical Resection Of Advanced Gastric Cancer In Perioperative Period

Objective: To evaluate the treatment of local advanced gastric cancer with neoadjuvantchemotherapy combined with laparoscopic surgery, by analyze the patient’s condition whenhe was admitted to hospital, after the chemotherapy, after the surgery, we also analyze thepostoperative recovery of the patient. To provide a clinic reference basis for those patients.Methods: All patients with local advanced gastric cancer were analyzed from September2010to May2011.There were46case in experimental group who were given two course ofchemotherapy with FOLFOX regimen prior to surgery, and a radical gastrectomy wasperformed21days later. As a control,36case accepted surgery without new adjuvantchemotherapy.Results: The operations were completed in all cases. In chemotherapy group, completeresponse was7, partial response was20, no change was11, progress disease was8,theoverall response was59%(27/46). The size of primary lesionsignificantly was reduced in24gastric cancer evaluate by epigastric enhancement CT and gastroscope, Pane-ndoscopyrevealed it`s low depth of invasion, small size of cancer, small size of peripheral lymph nodein chemotherapy group. The pathological section revealed there wereless cancer cell, uncleargland structure, no nucleolus cells,hyperplastic interstitial fibrous tissue and hyalinedegeneration of vascular wall in gastric cancer organization after chemotherapy.Comparewith the control group, the incidence rate of omentum adhesion and cancerous pyloricobstruction is lower in chemotherapy group(P<0.05),and the confidence of tissueembrittlement and serosa congestion in chemotherapy group is obvious. There was nosignificant change in operative time, intraoperative blood loss and dissected lymph nodenumber,complications incidence and pulmonary infection between two groups (P>0.05).onepatient died cause the stomach contents reflux. There was8patient with II stage of tumorbefore the chemotherapy in chemotherapy group, but after the chemotherapy the number of Istage and II stage of tumor is26.Conclusions The preoperative neoadjuvant chemotherapy combined with laparoscopicsurgery for advanced gastric cancer can significantly improved the resection rate and reducerecurrence rate and mortality rate, which is safe、effective.