[Effect of laparoscopy assisted vs. open radical gastrectomy on lymph node dissection in patients with gastric cancer].

OBJECTIVE

To explore the feasibility and efficacy of laparoscopy assisted radical gastrectomy on lymph node (LN) dissection for gastric cancer and to compare it with open gastrectomy.

METHODS

The clinical data of 934 patients with gastric cancer underwent radical resection from January 2007 to May 2010 were analyzed retrospectively. Among the patients, 506 cases received laparoscopy assisted gastrectomy (LAG group) and 428 cases received open gastrectomy (OG group). The number of retrieved LNs and the survival curve between the two groups was compared. Then, the relations between the number of dissected LNs and postoperative morbidity were analyzed.

RESULTS

For all patients, the mean number of dissected LNs was 29 ± 10, there was no significantly differences between LAG group and OG group (P < 0.05). While the number of the retrieved No.7, 8 LNs in LAG group were significantly more than those in OG group. No significant differences was found in the number of dissected LNs for the pT1-2 stages tumors between the two groups, but significantly greater number of LNs was harvested by LAG group in pT3 stage (P < 0.05). No significant differences were found in the number of dissected LNs in different gastrectomy types or extents of LN dissection between the two groups. In the first 50 cases, there were less dissected LNs in LAG group than that in OG group, while 51 cases later, there was no significantly differences in number of dissected LNS between the two groups (P > 0.05). The postoperative morbidity of LAG group and OG group was 11.1% and 20.1%, respectively (P < 0.05), but there was no significant correlations between the number of dissected LNs and postoperative morbidity in both groups.

CONCLUSIONS

With the improvement in surgical skills, laparoscopy-assisted radical gastrectomy with lymph node dissection is a safe and feasible procedure, and it is oncologically compatible with open gastrectomy. Suitable increment of dissected LN count would not increase the postoperative complication rate.