Clinical Experience on Laparoscopic Radical Surgery in Patients with Advanced Distal Gastric Cancer (Report of 26 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

KANG Boxiong , WANG Chen , LI Xusheng , FAN Yong , FU Jie

The Second Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China;

Corresponding author：

Keywords：

Laparoscopic surgery; Radical gastrectomy; Advanced gastric cancer; Open surgery

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ObjectiveTo summarized the clinical experience on laparoscopic radical surgery in patients with advanced distal gastric cancer. MethodsThe clinical data of 26 patients with advanced distant gastric cancer undergoing laparoscopic gastrectomy were retrospectively analyzed. ResultsLaparoscopic distal gastrectomy was performed successfully in all patients. The operation time was (283.2±27.6) min (270-450 min) and the blood loss was (178.4±67.4) ml (80-350 ml). The time of gastrointestinal function recovery was (2.8±1.2) d (2-4 d), out of bed activity time was (1.5±0.4) d (1-3 d) and liquid diet feeding was (3.5±1.4) d (3-4 d). The hospital stay was (10.0±2.6) d (7-13 d). The number of harvested lymph nodes was 11 to 34 (17.8±7.3). The distance from proximal surgical margin to tumor was (7.0±2.1) cm (5-12 cm) and the distance from distal surgical margin to tumor was (5.5±1.8) cm (4-8 cm), thus surgical margins were negative in all samples. All patients were followed up for 3-48 months (mean 18.5 months), two patients with poorly differentiated adenocarcinoma died of extensive metastasis in 13 and 18 months, respectively, and other patients survived well. ConclusionsLaparoscopic radical gastrectomy with D2 lymphadenectomy for advanced gastric cancer is safe and feasible. However, the advantage of laparoscopic technique over the conventional open surgery requires further study.

Citation： KANG Boxiong,WANG Chen,LI Xusheng,FAN Yong,FU Jie,.. Clinical Experience on Laparoscopic Radical Surgery in Patients with Advanced Distal Gastric Cancer (Report of 26 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(9): 966-968. doi: Copy

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1. Varela JE, Hiyashi M, Nguyen T, et al. Comparison of laparoscopic and open gastrectomy for gastric cancer [J]. Am J Surg, 2006, 192(6): 837842.
2. 余佩武．腹腔镜胃癌根治术的原则与评价 [J]．中国普外基础与临床杂志， 2009， 16(1)： 15．.
3. Suh SH, Kwon HC, Jo JH, et al. Oxaliplatin with biweekly low dose leucovorin and bolus and continuous infusion of 5fluorouracil (modified FOLFOX4) as a salvage therapy for patients with advanced gastric cancer [J]. Cancer Res Treat, 2005, 37(5): 279283.
4. Cavanna L, Artioli F, Codignola C, et al. Oxaliplatin in combination with 5fluorouracil (5FU) and leucovorin (LV) in patients with metastatic gastric cancer (MGC) [J]. Am J Clin Oncol, 2006, 29(4): 371375.
5. Nardi M, Azzarello D, Maisano R, et al. FOLFOX4 regimen as fistline chemotherapy in elderly patients with advanced gastric cancer: a safety study [J]. J Chemother, 2007, 19(1): 8589.
6. Nakajima T. Gastric cancer treatment guidelines in Japan [J]. Gastric Cancer, 2002, 5(1): 15.
7. 中华医学会外科分会腹腔镜与内镜外科学组．腹腔镜胃恶性肿瘤手术操作指南(2007年版)[J]．外科理论与实践， 2007, 12(6): 610614．.
8. Sarela AI. Entirely laparoscopic radical gastrectomy for adenocarcinoma: lymph node yield and resection margins [J]. Surg Endosc, 2009, 23(1): 153160.
9. 余佩武．腹腔镜胃癌手术的进展与展望 [J]．中国普外基础与临床杂志， 2011， 18(2)： 105109．.
10. 李国新，张策，余江．腹腔镜辅助远端胃癌D2根治术: 基于解剖的艺术 [J]．外科理论与实践， 2007， 12(6)： 533538．.
11. 郑勇斌，童仕伦，谭海燕，等．超声刀在腹腔镜胃癌根治手术中的应用 [J]．中国普外基础与临床杂志， 2009， 16(10)： 781784．.
12. Mohri Y, Tonouchi H, Tanaka K, et al. Ultrasonically activated shears in gastrectomy for large gastric cancers [J]. Surg Today, 2007, 37(12): 10601063.
13. 兰晶，管洪庚，秦磊，等．腹腔镜辅助与开腹胃癌根治术治疗进展期胃癌中的效果比较[J]．中华实验外科杂志， 2010， 27(12)： 19331936．.
14. 郑民华，藏路．腹腔镜胃癌根治术的现状[J]．腹腔镜外科杂志， 2010， 15(3)： 161163．.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Experience on Laparoscopic Radical Surgery in Patients with Advanced Distal Gastric Cancer (Report of 26 Cases)

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