| Objective:To compare and analyze the clinical data of laparoscopic radical gastrectomy and laparotomy,and to investigate the feasibility,safety and therapeutic effect of laparoscopic radical gastrectomy for Advanced gastric cancer.Methods:A total of 33 patients with advanced gastric cancer of laparoscopic radical gastrectomy in Affiliated Hospital of Taishan Medical College from June 2015 to December 2016 were collected.A contrastive study was performed comparing the surgical group of surgeons in 30 cases of open radical resection with advanced gastric cancer.General data,related operation index,postoperative recovery,the number of lymph node dissection and postoperative complications of the patients in laparoscopic and laparotomy group were analyzed.Results:Two groups of patients were successfully completed surgery.Laparoscopic group of patients were completed laparoscopic surgery,no conversion to open surgery,no serious intraoperative intra-abdominal hemorrhage,peripheral organ damage and no deaths.There was no significant difference between the two groups in gender composition,age distribution,body mass index and postoperative pathological stage(P>0.05).Operation time: LRG groups(234.2±38.3)min,ORG groups(206.4±26.1)min,It means the difference between the two groups was statistically significant(P<0.05).The amount of bleeding: LRG groups(115.9±33.2)ml,ORG groups(190.6±76.7)ml;The average length of incision: LRG groups(6.3±1.4)cm,ORG groups(20.7±2.7)cm;Pain score after 24 hours operation: LRG groups(3.0±0.9),ORG groups(5.7±1.1);the first exhaust time after operation: LRG groups(2.2±0.9)days,ORG groups(3.4±1.2)days;The first liquid diet time: LRG groups(5.1±2.0)days,ORG groups(6.7±2.3)days;Postoperative hospitalization time: LRG groups(10.3±1.4)days,ORG groups(13.8±2.1)days.The differences were statistically significant(P<0.05),descripting laparoscopic surgery has advantages of less bleeding,less pain and quicker recovery.The number of lymph node dissection: LRG groups(33.4±14.7),ORG groups(30.1±9.1);positive margin rate was 0;tumor distance from the cut edge: LRG groups distance of tumor to proximal incisal margin(6.71±1.62)cm,the distance of the tumor from the distal incisal margin(6.30±1.01)cm,ORG groups distance of tumor to proximal incisal margin(6.28±0.90)cm,the distance of the tumor from the distal incisal margin(6.57±0.84)cm;The total incidence of complications : LRG groups(12.12%),ORG groups(20.00%).It had no statistical significance(P>0.05),and means laparoscopic surgery achieving laparotomy tumor radical effect without increasing the risk of operation.Conclusion:Laparoscopic D2 radical resection of gastric cancer compared with open radical gastrectomy with less trauma,less bleeding,less postoperative pain,quick recovery,does not increase the risk of surgery related,is safe and feasible,and can achieve the same radical effect as laparotomy.Proficient in the peripheral blood vessels,bone and other microscopic anatomy,composed of stable and tacit understanding of the surgical team,help to shorten the learning curve,reduce the incidence of complications. |
