Wang Dao-rong, Zhao Jian-guo, Yu Hai-feng, Wang Liu-hua, Jiang Guo-qing, Li Yong-kun, Chen Jie
Department of Gastrointestinal Surgery, Yangzhou University, Jiangsu Yangzhou, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2012 Sep;15(9):964-6.
To investigate the safety and feasibility of laparoscopic D2 gastrectomy for advanced gastric cancer.
The clinical data of 210 cases of laparoscopic gastrectomy and 180 cases of open gastrectomy for radical (D2) gastrectomy from May 2007 to Dec 2010 were analyzed retrospectively.
A total of 206 cases underwent laparoscopic-assisted surgery with 4 conversions. Compared to the open group, the laparoscopic group was associated with less bleeding [(208±38) ml vs. (300±52) ml, P<0.05], quicker postoperative recovery of bowel function [(2.9±0.7) d vs. (3.9±1.8) d, P<0.05], shorter postoperative length of hospital stay[(12.8±6.2) d vs. (15.6±6.8) d, P<0.05], longer operative time [(258±42) min vs. (193±30) min, P<0.05]. The number of lymph node harvested was 20.5±1.9 in the laparoscopic group and 25.8±1.5 in the open group, and the postoperative complication rate was 8.1% (17/201) vs. 8.5% (15/180), and differences were not statistically significant (both P>0.05). The recurrence rate was 2.9% (6/210) and 2.8% (5/180), and the 3-year overall survival rate was 35.6% and 37.8%, the differences were not statistically significant (both P>0.05).
Laparoscopic radical gastrectomy for gastric cancer is safe and effective, which can reach the same range of lymph node dissection as open gastric cancer surgery and similar survival rate.
探讨腹腔镜D2根治性胃癌切除术的安全性及可行性。
回顾性分析2007年5月至2010年12月期间210例行腹腔镜胃癌根治术及180例行开腹胃癌根治术（D2）患者的临床资料。
共206例患者接受腹腔镜辅助手术，4例中转开腹。与开腹组相比，腹腔镜组术中出血少[（208±38）ml比（300±52）ml，P<0.05]，术后肠功能恢复快[（2.9±0.7）d比（3.9±1.8）d，P<0.05]，术后住院时间短[（12.8±6.2）d比（15.6±6.8）d，P<0.05]，手术时间长[（258±42）min比（193±30）min，P<0.05]。腹腔镜组清扫淋巴结数为20.5±1.9枚，开腹组为25.8±1.5枚，术后并发症发生率分别为8.1%（17/201）和8.5%（（15/180），差异无统计学意义（P均>0.05）。复发率分别为2.9%（6/210）和2.8%（5/180），3年总生存率分别为35.6%和37.8%，差异无统计学意义（P均>0.05）。
腹腔镜胃癌根治术安全有效，淋巴结清扫范围及生存率与开腹手术相近。
