A comparative study on laparoscopic-assisted and open distal gastrectomy for advanced gastric cancer

/Zhao Yongliang

(趙永亮，Dept Gen Surg，Center Minimal Invasive Gastroint Surg，Southwest Hosp，3rd Mil Med Univ，Chongqing 400038)…∥Chin J Gen Surg.-2011，14(8).-713～ 716

ObjectiveTo evaluate the feasibility，safety and the long-term outcomes of laparoscopy-assisted distal gastrectomy (LADG)for advanced gastric cancer(AGC).MethodsWe retrospectively analyzed the clinical and follow-up data of 346 cases after LADG from January 2004 to June 2009，compared with 313 cases after conventional open distal gastrectomy(ODG)for advanced gastric cancer at the same period at our hospital.The surgical safety，postoperative complications，survival rate，and the recurrence and metastasis of cancer were compared.ResultsThere was no significant difference at the average time of LADG and ODG procedures(211±56)min vs.(204 ±41)min，but blood loss during operation and length of incision in LADG group were significantly less than in the ODG group.The proximal and distal length were，respectively，(6.3 ±2.0)cm and(5.7±1.7)cm in LADG group and(6.3 ± 2.1)cm and(5.6 ± 1.6)cm in ODG group，the difference was not significant.The number of lymph node dissections was also similar:(33±13)in LADG group and(33±16)in ODG group.The incidence of postoperative complications in LADG group was significantly lower than that in ODG group(6.7%vs.13.1%，P ＜0.05).During the followup period of 6-72 months(average 37 months)，the 1-，3-and 5-year survival rates were，respectively，87.2%，57.2%and 50.3%in LADG group and 87.1%，54.1%and 49.2%in ODG group，the difference was not significant.The differences in recurrence and metastasis between the two groups were not statistically significant.ConclusionLaparoscopy-assisted gastrectomy for advanced gastric cancer is not significantly different with open surgery in postoperative survival rate or recurrence.It is less traumatic and of fewer complications.10 refs，2 tabs.