Effect and Safety of Laparoscopic D2 Radical Gastrectomy for Advanced Gastric Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LUHong-wei , ZHANGYa-fei , JIHong , WANGJin-long ,  LIYi-ming

Department of General Surgery, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China;

Corresponding author：

LIYi-ming, Email: liyiming2003@sina.com

Keywords：

Advanced gastric cancer; Laparoscopy; Laparotomy; D2 radical gastrectomy

DOI：

10.7507/1007-9424.20150085

Video：

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Objective To compare the effect and safety between laparoscopic versus laparotomy D2 radical gastrectomy for advanced gastric cancer. Methods Two hundred and seventeen patients with advanced gastric cancer who were treated in our hospital from March 2011 to March 2014 were selected as research objects. According to surgical method, they were divided into laparoscopy group (103 patients received laparoscopic D2 radical gastrectomy) and laparotomy group (114 patients received laparotomy D2 radical gastrectomy). Comparison of the surgical effect-related indicators between 2 groups was performed. Results In the aspect of intra-operative indicators:the operation time, proximal margin length, distal margin length, and the number of removal lymph node between the 2 groups did not significantly differed with each other (P>0.05); while the bleeding volume and the length of incision in laparoscopy group were significantly less (shorter) than those of laparotomy group (P<0.05). In the aspect of post-operative indicators:the time to first flatus, time to resumed oral intake, time to ambulation, post-operative hospital stay, time of analgesics given, and the total incidence of postoperative complication in laparoscopy group were significantly shorter (less or lower) than those of laparotomy group (P<0.05), the operating cost in laparoscopy group was significantly higher than that of the laparotomy group (P<0.05), but there was no significant difference in total treatment cost, mortality of gastric cancer, and recurrence or metastasis rate between the 2 groups (P>0.05). Conclusions Both laparoscopic and laparotomy D2 radical gastrectomy in treatment of advanced gastric cancer can obtain good clinical effect. But compared with laparotomy D2 radical gastrectomy, laparoscopic D2 radical gastrectomy can reduce operative wound, reduce incidence of complications, improve postoperative recovery, and has higher safety.

Citation： LUHong-wei, ZHANGYa-fei, JIHong, WANGJin-long, LIYi-ming. Effect and Safety of Laparoscopic D2 Radical Gastrectomy for Advanced Gastric Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(3): 317-321. doi: 10.7507/1007-9424.20150085 Copy

1.	王蓓, 吕成余, 谢洪虎. 351例胃癌术后患者的预后因素分析. 中国普外基础与临床杂志, 2012, 19(7):743-748.
2.	李松, 李延茂, 丛山. 腹腔镜胃癌根治术与开腹手术安全性的对比研究. 沈阳医学院学报, 2013, 15(2): 85-87.
3.	余佩武, 罗华星. 腹腔镜胃癌根治术:未来治疗胃癌的标准手术. 第三军医大学学报, 2013, 35(18):1889-1892.
4.	Li Y, Wang J. Station 10 lymph node dissections in laparoscopic-assisted spleen-preserving radical gastrectomy for advanced proximal gastric cancer. Chinese J Cancer Res, 2013, 25(4):465-467.
5.	黄昌明, 林建贤, 郑朝辉, 等. 腹腔镜辅助胃癌根治术后并发症及其相关因素分析. 中华胃肠外科杂志, 2011, 14(5):347-350.
6.	中华医学会外科分会腹腔镜与内镜外科学组. 腹腔镜胃癌手术操作指南(2007版). 中华消化外科杂志, 2007, 6(6): 476-480.
7.	Japanese Gastric Cancer Association. Japanese gastric cancer treat-ment guidelines 2010 (ver. 3). Gastric Cancer, 2011, 14(2):113-123.
8.	Sobin LH, Wittekind C. International Union Against Cancer (UICC) TNM classification of malignant tumours. 6th ed. New York:Wiley, 2002:106-115.
9.	The National Comprehensive Cancer Network. NCCN clinical prac-tice guidelines in oncology-colon cancer V3. 2011. www.nccn.org.
10.	Kitano S, Iso Y, Moriyama M, et al. Laparoscopy assisted BillrothⅠgastrectomy. Surg Laparosc Endosc, 1994, 4(2):146-148.
11.	胡伟国. 腹腔镜下早期胃癌手术的消化道重建. 中国普外基础与临床杂志, 2013, 20(6):596-599.
12.	余佩武. 腹腔镜胃癌手术的进展与展望. 中国普外基础与临床杂志, 2011, 18(2):105-109.
13.	黄昌明, 林建贤. 腹腔镜胃癌根治术合理应用及疗效评价. 中国实用外科杂志, 2011, 31(8):672-674.
14.	Hottenrott C. The long-term efficacy of laparoscopic surgery in early and advanced gastric cancer. Surg Endosc, 2012, 26(12):3695-3696.
15.	Moisan F, Norero E, Slako M, et al. Completely laparoscopic versus open gastrectomy for early and advanced gastric cancer:a matched cohort study. Surg Endosc, 2012, 26(3):661-672.
16.	刘文韬, 刘福坤. 2002年版日本胃癌治疗规范. 中华胃肠外科杂志, 2003, 6(2):131-132.
17.	Goh PM, Khan AZ, So JB, et al. Early experience with laparoscopic radical gastrectomy for advanced gastric cancer. Surg Laparosc Endosc Percutan Tech, 2001, 11(2):83-87.
18.	Lee JH, Han HS, Lee JH. A prospective randomized study comparing open vs laparoscopy-assisted distal gastrectomy in early gastric cancer. Surg Endosc, 2005, 19(2):168-173.
19.	Shinohara T, Satoh S, Kanaya S, et al. Laparoscopic versus open D2 gastrectomy for advanced gastric cancer:a retrospective cohort study. Surg Endosc, 2013, 27(1):286-294.
20.	Zhou D, Quan Z, Wang J, et al. Laparoscopic-assisted versus open distal gastrectomy with D2 lymph node resection for advanced gastric cancer:effect of learning curve on short-term outcomes. a meta-analysis. J Laparoendosc Adv Surg Tech A, 2014, 24(3):139-150.
21.	Shuang J, Qi S, Zheng J, et al. A case-control study of laparoscopy-assisted and open distal gastrectomy for advanced gastric cancer. J Gastrointest Surg, 2011, 15(1):57-62.
22.	Zhao Y, Yu P, Hao Y, et al. Comparison of outcomes for laparoscopically assisted and open radical distal gastrectomy with lymphadenectomy for advanced gastric cancer. Surg Endosc, 2011, 25(9):2960-2966.
23.	Kim JP, Yu HJ, Lee JH. Results of immunochemosurgery for gastric carcinoma. Hepatogastroenterology, 2001, 48(41):1227-1230.
24.	Lu J, Huang CM, Zheng CH, et al. Learning curve of laparoscopy spleen-preserving splenic hilar lymph node dissection for advanced upper gastric cancer. Hepatogastroenterology, 2013, 60(122):296-300.
25.	Hamabe A, Omori T, Tanaka K, et al. Comparison of long-term results between laparoscopy-assisted gastrectomy and open gastrectomy with D2 lymph node dissection for advanced gastric cancer. Surg Endosc, 2012, 26(6):1702-1709.

1. 王蓓, 吕成余, 谢洪虎. 351例胃癌术后患者的预后因素分析. 中国普外基础与临床杂志, 2012, 19(7):743-748.
2. 李松, 李延茂, 丛山. 腹腔镜胃癌根治术与开腹手术安全性的对比研究. 沈阳医学院学报, 2013, 15(2): 85-87.
3. 余佩武, 罗华星. 腹腔镜胃癌根治术:未来治疗胃癌的标准手术. 第三军医大学学报, 2013, 35(18):1889-1892.
4. Li Y, Wang J. Station 10 lymph node dissections in laparoscopic-assisted spleen-preserving radical gastrectomy for advanced proximal gastric cancer. Chinese J Cancer Res, 2013, 25(4):465-467.
5. 黄昌明, 林建贤, 郑朝辉, 等. 腹腔镜辅助胃癌根治术后并发症及其相关因素分析. 中华胃肠外科杂志, 2011, 14(5):347-350.
6. 中华医学会外科分会腹腔镜与内镜外科学组. 腹腔镜胃癌手术操作指南(2007版). 中华消化外科杂志, 2007, 6(6): 476-480.
7. Japanese Gastric Cancer Association. Japanese gastric cancer treat-ment guidelines 2010 (ver. 3). Gastric Cancer, 2011, 14(2):113-123.
8. Sobin LH, Wittekind C. International Union Against Cancer (UICC) TNM classification of malignant tumours. 6th ed. New York:Wiley, 2002:106-115.
9. The National Comprehensive Cancer Network. NCCN clinical prac-tice guidelines in oncology-colon cancer V3. 2011. www.nccn.org.
10. Kitano S, Iso Y, Moriyama M, et al. Laparoscopy assisted BillrothⅠgastrectomy. Surg Laparosc Endosc, 1994, 4(2):146-148.
11. 胡伟国. 腹腔镜下早期胃癌手术的消化道重建. 中国普外基础与临床杂志, 2013, 20(6):596-599.
12. 余佩武. 腹腔镜胃癌手术的进展与展望. 中国普外基础与临床杂志, 2011, 18(2):105-109.
13. 黄昌明, 林建贤. 腹腔镜胃癌根治术合理应用及疗效评价. 中国实用外科杂志, 2011, 31(8):672-674.
14. Hottenrott C. The long-term efficacy of laparoscopic surgery in early and advanced gastric cancer. Surg Endosc, 2012, 26(12):3695-3696.
15. Moisan F, Norero E, Slako M, et al. Completely laparoscopic versus open gastrectomy for early and advanced gastric cancer:a matched cohort study. Surg Endosc, 2012, 26(3):661-672.
16. 刘文韬, 刘福坤. 2002年版日本胃癌治疗规范. 中华胃肠外科杂志, 2003, 6(2):131-132.
17. Goh PM, Khan AZ, So JB, et al. Early experience with laparoscopic radical gastrectomy for advanced gastric cancer. Surg Laparosc Endosc Percutan Tech, 2001, 11(2):83-87.
18. Lee JH, Han HS, Lee JH. A prospective randomized study comparing open vs laparoscopy-assisted distal gastrectomy in early gastric cancer. Surg Endosc, 2005, 19(2):168-173.
19. Shinohara T, Satoh S, Kanaya S, et al. Laparoscopic versus open D2 gastrectomy for advanced gastric cancer:a retrospective cohort study. Surg Endosc, 2013, 27(1):286-294.
20. Zhou D, Quan Z, Wang J, et al. Laparoscopic-assisted versus open distal gastrectomy with D2 lymph node resection for advanced gastric cancer:effect of learning curve on short-term outcomes. a meta-analysis. J Laparoendosc Adv Surg Tech A, 2014, 24(3):139-150.
21. Shuang J, Qi S, Zheng J, et al. A case-control study of laparoscopy-assisted and open distal gastrectomy for advanced gastric cancer. J Gastrointest Surg, 2011, 15(1):57-62.
22. Zhao Y, Yu P, Hao Y, et al. Comparison of outcomes for laparoscopically assisted and open radical distal gastrectomy with lymphadenectomy for advanced gastric cancer. Surg Endosc, 2011, 25(9):2960-2966.
23. Kim JP, Yu HJ, Lee JH. Results of immunochemosurgery for gastric carcinoma. Hepatogastroenterology, 2001, 48(41):1227-1230.
24. Lu J, Huang CM, Zheng CH, et al. Learning curve of laparoscopy spleen-preserving splenic hilar lymph node dissection for advanced upper gastric cancer. Hepatogastroenterology, 2013, 60(122):296-300.
25. Hamabe A, Omori T, Tanaka K, et al. Comparison of long-term results between laparoscopy-assisted gastrectomy and open gastrectomy with D2 lymph node dissection for advanced gastric cancer. Surg Endosc, 2012, 26(6):1702-1709.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect and Safety of Laparoscopic D2 Radical Gastrectomy for Advanced Gastric Cancer

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