Laparoscopic D2 Gastrectomy For Advanced Gastric Cancer

Objective:The aim of the study is to compare prognosis and safety evaluation between laparoscopic D2 gastrectomy and open D2 gastrectomy.Methods:Between October 2008 and February 2009,67 patients who are in the clinical T2, T3, or T4 tumors underwent laparoscopic (n=37) or open (n= 30) radical gastrectomy with D2 lymph node dissection were included in this study. Clinical and pathological data extracted and analyzed including:sex, age, BMI, underlying diseases, time of operation, bleeding volume, degrees of differentiation, time of recovery etc. The long-term outcomes of these two groups were also compared.Results:Laparoscopic D2 gastrectomy had less intraoperative injury and faster postoperative recovery, compared with open D2 gastrectomy. During the perioperative period, there is no death in the two groups. The recurrence rate of laparoscopic D2 gastrectomy and open group were 29.7 % and 30.0%, respectively (P=0.402). The five year disease free survival rates were 64.7% and 64.3%(P=0.737) in the laparoscopic group and open group. The five year overall survival rates were 67.6% and 67.9%(P =0.968) in the laparoscopic group and open group. There were no statistical significance between the two groups.Conclusions:Laparoscopic D2 gastrectomy provides acceptable morbidity and low recurrence rates. The operation has many advantages like other laparoscopic surgery, including faster postoperative recovery and short hospital stay. Laparoscopic D2 gastrectomy provides a better choice than open D2 gastrectomy for patients with advanced gastric cancer.