Therapeutic effect of laparoscopy-assisted D2 radical gastrectomy in 106 patients with advanced gastric cancer.

Objective: To explore the feasibility and short-term effect of laparoscopy-assisted D2 radical gastrectomy for advanced gastric cancer.

Methods: A total of 239 patients with advanced gastric cancer underwent D2 radical gastrectomy between March 2009 and June 2011, from which 106 patients underwent laparoscopic surgery (laparoscopy group) and 133 patients underwent open surgery (open surgery group). The intraoperative and postoperative condition, number of lymph node removed, complications and mortality rates between the two groups were compared.

Results: The operation time (268±51 min) and the number of lymph node removed (29.1+6.1) in the laparoscopy group were comparable with the operation time (268±49 min) and the number of lymph node removed (30.2±7.0) in the open surgery group, while there were significant differences in the intraoperative bleeding (134±66 vs 289±139 ml), intraoperative blood infusion cases (5 vs 19), time to first postoperative flatus (3.4±0.9 vs 5.0±1.4 days), time to first taking liquid food (7.3±1.3 vs 8.1±1.4 days) and postoperative hospital stay (12.8±2.6 vs 14.5±3.1 days) between the two groups (p<0.05). These results favored the laparoscopy group. The incidence of postoperative complications in the laparoscopy and open surgery group were 14.1 and 24.8, respectively (p<0.05). Compared with the open surgery, the laparoscopic surgery significantly reduced the incidence of pulmonary infection (p<0.05). There was no significant difference in the postoperative short-term survival rate between the two groups (p>0.05).

Conclusions: Laparoscopy-assisted D2 gastrectomy for advanced gastric cancer is advantageous in terms of safety and feasibility, rapid postoperative recovery and few complications. Both groups gave comparable results in terms of lymph node dissection and short-term survival.