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, 呂成余, 謝洪虎. 351例胃癌術后患者的預后因素分析. 中國普外基礎與臨床雜志, 2012, 19(7):743-748.
2.	李松, 李延茂, 叢山. 腹腔鏡胃癌根治術與開腹手術安全性的對比研究. 沈陽醫學院學報, 2013, 15(2): 85-87.
3.	余佩武, 羅華星. 腹腔鏡胃癌根治術:未來治療胃癌的標準手術. 第三軍醫大學學報, 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.	黃昌明, 林建賢, 鄭朝輝, 等. 腹腔鏡輔助胃癌根治術后并發癥及其相關因素分析. 中華胃腸外科雜志, 2011, 14(5):347-350.
6.	中華醫學會外科分會腹腔鏡與內鏡外科學組. 腹腔鏡胃癌手術操作指南(2007版). 中華消化外科雜志, 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.	胡偉國. 腹腔鏡下早期胃癌手術的消化道重建. 中國普外基礎與臨床雜志, 2013, 20(6):596-599.
12.	余佩武. 腹腔鏡胃癌手術的進展與展望. 中國普外基礎與臨床雜志, 2011, 18(2):105-109.
13.	黃昌明, 林建賢. 腹腔鏡胃癌根治術合理應用及療效評價. 中國實用外科雜志, 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.	劉文韜, 劉福坤. 2002年版日本胃癌治療規范. 中華胃腸外科雜志, 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, 呂成余, 謝洪虎. 351例胃癌術后患者的預后因素分析. 中國普外基礎與臨床雜志, 2012, 19(7):743-748.
2. 李松, 李延茂, 叢山. 腹腔鏡胃癌根治術與開腹手術安全性的對比研究. 沈陽醫學院學報, 2013, 15(2): 85-87.
3. 余佩武, 羅華星. 腹腔鏡胃癌根治術:未來治療胃癌的標準手術. 第三軍醫大學學報, 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. 黃昌明, 林建賢, 鄭朝輝, 等. 腹腔鏡輔助胃癌根治術后并發癥及其相關因素分析. 中華胃腸外科雜志, 2011, 14(5):347-350.
6. 中華醫學會外科分會腹腔鏡與內鏡外科學組. 腹腔鏡胃癌手術操作指南(2007版). 中華消化外科雜志, 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. 胡偉國. 腹腔鏡下早期胃癌手術的消化道重建. 中國普外基礎與臨床雜志, 2013, 20(6):596-599.
12. 余佩武. 腹腔鏡胃癌手術的進展與展望. 中國普外基礎與臨床雜志, 2011, 18(2):105-109.
13. 黃昌明, 林建賢. 腹腔鏡胃癌根治術合理應用及療效評價. 中國實用外科雜志, 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. 劉文韜, 劉福坤. 2002年版日本胃癌治療規范. 中華胃腸外科雜志, 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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