Clinical Comparative study of Short-Term Outcomes of D2 Radical Distal Gastrectomy for Gastric Cancer Between Hand Assisted Laparoscopic and Traditonal Open Techniques_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 CAOYong-kuan , ZHANGGuo-hu , WANGPei-hong , LUOGuo-de , ZHANGLin , LIULi-ye , GONGJia-qing , ZHOUJun , HUANGLing , GANWei , SONGYa-ning

Gastrointestinal Ward of PLA General Surgery Centre, Chengdu Army General Hospital, Chengdu 610083, Sichuan Province, China;

Corresponding?author：

CAOYong-kuan, Email: caoyok@163.com

Keywords：

Gastric cancer; Hand-assisted laparoscopy; Radical gastrectomy

DOI：

10.7507/1007-9424.20160250

Video：

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Objective To analyze short-term outcomes of hand assisted laparoscopic (HAL) D2 radical distal gastrectomy for gastric cancer and summarize clinical experiences. Methods The clinical data of 199 patients with gastric cancer undergoing D2 radical distal gastrectomy from December 2010 to December 2013 in this hospital were analyzed. HAL (HAL group, n=92) and traditonal open (TO group, n=107) D2 radical distal gastrectomy were performed. The operation time, incision length, intraoperative blood loss, number of lymph nodes harvested, postoperative hospital stay, and postoperative complications were compared between these two groups. Results There was no residue of cancer cells at the surgical margin in the HAL group and the TO group. Compared with the TO group, the average incision length was obviously shorter (P < 0.01) and the average intraoperative blood loss was obviously less (P < 0.05) in the HAL group. The average operation time, the average number of lymph nodes harvested, and the average postoperative hospital stay had no significant differences between the HAL group and the TO group (P > 0.05). One case was died of unknown gastrointestinal bleeding in the HAL group and the TO group, respectively. The postoperative complication rate was 9.78% (9/92) in the HAL group and 11.21% (12/107) in the TO group, there was no significant difference (P > 0.05). Conclusions HAL D2 radical distal gastrectomy for gastric cancer don't increase operation time. It has some advantages of minimal invasion and safety as compared with traditional open surgery.

Citation： CAOYong-kuan, ZHANGGuo-hu, WANGPei-hong, LUOGuo-de, ZHANGLin, LIULi-ye, GONGJia-qing, ZHOUJun, HUANGLing, GANWei, SONGYa-ning. Clinical Comparative study of Short-Term Outcomes of D2 Radical Distal Gastrectomy for Gastric Cancer Between Hand Assisted Laparoscopic and Traditonal Open Techniques. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(8): 953-956. doi: 10.7507/1007-9424.20160250 Copy

1.	?翟志偉, 李明, 顧晉.手輔助腹腔鏡外科技術在腹部外科手術中的應用.中華胃腸外科雜志, 2012, 15(8):862-863.
2.	Vogel JD, Lian L, Kalady MF, et al. Hand-assisted laparoscopic right colectomy:how does it compare to conventional laparoscopy? J Am Coll Surg, 2011, 212(3):367-372.
3.	盛勤松, 劉凡隆, 陳文斌, 等.手輔助腹腔鏡結直腸癌根治術111例短期療效分析.中華胃腸外科雜志, 2011, 14(4):288-289.
4.	宋武, 韓方海, 何裕隆, 等.手輔助與腹腔鏡外科治療結直腸癌的臨床療效觀察.中華醫學雜志, 2011, 91(35):2485-2487.
5.	劉凡隆, 葉鋒, 林建江, 等.手輔助腹腔鏡全結腸切除術治療結腸無力癥的臨床研究.中華外科雜志, 2007, 45(19):1305-1307.
6.	曹永寬, 劉立業, 羅國德, 等.手助腹腔鏡行胃癌D2根治術的手術安全與技術路徑探討.中國普通外科雜志, 2012, 21(4):373-376.
7.	Gong JQ, Cao YK, Wang YH, et al. Three-step hand-assisted laparoscopic surgery for radical distal gastrectomy:an effective surgical approach. Int J Clin Exp Med, 2014, 7(8):2156-2164.
8.	Ohki J, Nagai H, Hyodo M, et al. Hand-assisted laparoscopic distal gastrectomy with abdominal wall-lift method. Surg Endosc, 1999, 13(11):1148-1150.
9.	Ikeda Y, Sasaki Y, Niimi M, et al. Hand-assisted laparoscopic proximal gastrectomy with jejunal interposition and lymphadenectomy. J Am Coll Surg, 2002, 195(4):578-581.
10.	Usui S, Inoue H, Yoshida T, et al. Hand-assisted laparoscopic total gastrectomy for early gastic cancer. Surg Laparosc Endosc Percutan Tech, 2003, 13(5):304-307.
11.	胡建昆, 楊昆, 陳心足, 等.手輔助腹腔鏡胃癌根治術2例報道.中國普外基礎與臨床雜志, 2011, 18(5):520-522.
12.	胡巍.手輔助腹腔鏡胃癌根治術55例.臨床醫學, 2013, 33(4):62-63.
13.	Wong SK, Tsui DK, Li MK. Laparoscopic distal gastrectomy for gastric cancer:initial experience on hand-assisted technique and totally laparoscopic technique. Surg Laparosc Endosc Percutan Tech, 2009, 19(4):298-304.
14.	曹永寬, 劉立業, 周均, 等.手輔助腹腔鏡與腹腔鏡輔助和開腹胃癌根治性切除術的臨床比較.中華胃腸外科雜志, 2012, 15(7):740-742.
15.	劉逸, 揭志剛, 李正榮, 等.改良手輔助腹腔鏡胃癌根治術手術技巧探討.中華胃腸外科雜志, 2013, 16(10):1009-1010.
16.	曹永寬, 周均, 劉立業, 等.手輔助腹腔鏡與腹腔鏡輔助胃癌D2根治術的臨床對照研究.中國普外基礎與臨床雜志, 2012, 19(11):1208-1212.
17.	Gong JQ, Cao YK, Li YM, et al. Hand-assisted laparoscopic versus laparoscopy-assisted D2 radical gastrectomy:a prospective study. Surg Endosc, 2014, 28(10):2998-3006.
18.	Gong JQ, Cao YK, Wang YH, et al. Learning curve for hand-assisted laparoscopic D2 radical gastrectomy. World J Gastroenterol, 2015, 21(5):1606-1613.
19.	Zhang GT, Zhang XD. A hand-assisted laparoscopic distal gastrectomy can be an effective way in obese patients. Surg Laparosc Endosc Percutan Tech, 2013, 23(2):145-148.
20.	Gong JQ, Cao YK, Wang YH, et al. Three-step hand-assisted laparoscopic D2 radical gastrectomy for Chinese obese patients:a highly efficient and feasible surgical approach. J Cancer, 2015, 6(2):120-127.

1. ?翟志偉, 李明, 顧晉.手輔助腹腔鏡外科技術在腹部外科手術中的應用.中華胃腸外科雜志, 2012, 15(8):862-863.
2. Vogel JD, Lian L, Kalady MF, et al. Hand-assisted laparoscopic right colectomy:how does it compare to conventional laparoscopy? J Am Coll Surg, 2011, 212(3):367-372.
3. 盛勤松, 劉凡隆, 陳文斌, 等.手輔助腹腔鏡結直腸癌根治術111例短期療效分析.中華胃腸外科雜志, 2011, 14(4):288-289.
4. 宋武, 韓方海, 何裕隆, 等.手輔助與腹腔鏡外科治療結直腸癌的臨床療效觀察.中華醫學雜志, 2011, 91(35):2485-2487.
5. 劉凡隆, 葉鋒, 林建江, 等.手輔助腹腔鏡全結腸切除術治療結腸無力癥的臨床研究.中華外科雜志, 2007, 45(19):1305-1307.
6. 曹永寬, 劉立業, 羅國德, 等.手助腹腔鏡行胃癌D2根治術的手術安全與技術路徑探討.中國普通外科雜志, 2012, 21(4):373-376.
7. Gong JQ, Cao YK, Wang YH, et al. Three-step hand-assisted laparoscopic surgery for radical distal gastrectomy:an effective surgical approach. Int J Clin Exp Med, 2014, 7(8):2156-2164.
8. Ohki J, Nagai H, Hyodo M, et al. Hand-assisted laparoscopic distal gastrectomy with abdominal wall-lift method. Surg Endosc, 1999, 13(11):1148-1150.
9. Ikeda Y, Sasaki Y, Niimi M, et al. Hand-assisted laparoscopic proximal gastrectomy with jejunal interposition and lymphadenectomy. J Am Coll Surg, 2002, 195(4):578-581.
10. Usui S, Inoue H, Yoshida T, et al. Hand-assisted laparoscopic total gastrectomy for early gastic cancer. Surg Laparosc Endosc Percutan Tech, 2003, 13(5):304-307.
11. 胡建昆, 楊昆, 陳心足, 等.手輔助腹腔鏡胃癌根治術2例報道.中國普外基礎與臨床雜志, 2011, 18(5):520-522.
12. 胡巍.手輔助腹腔鏡胃癌根治術55例.臨床醫學, 2013, 33(4):62-63.
13. Wong SK, Tsui DK, Li MK. Laparoscopic distal gastrectomy for gastric cancer:initial experience on hand-assisted technique and totally laparoscopic technique. Surg Laparosc Endosc Percutan Tech, 2009, 19(4):298-304.
14. 曹永寬, 劉立業, 周均, 等.手輔助腹腔鏡與腹腔鏡輔助和開腹胃癌根治性切除術的臨床比較.中華胃腸外科雜志, 2012, 15(7):740-742.
15. 劉逸, 揭志剛, 李正榮, 等.改良手輔助腹腔鏡胃癌根治術手術技巧探討.中華胃腸外科雜志, 2013, 16(10):1009-1010.
16. 曹永寬, 周均, 劉立業, 等.手輔助腹腔鏡與腹腔鏡輔助胃癌D2根治術的臨床對照研究.中國普外基礎與臨床雜志, 2012, 19(11):1208-1212.
17. Gong JQ, Cao YK, Li YM, et al. Hand-assisted laparoscopic versus laparoscopy-assisted D2 radical gastrectomy:a prospective study. Surg Endosc, 2014, 28(10):2998-3006.
18. Gong JQ, Cao YK, Wang YH, et al. Learning curve for hand-assisted laparoscopic D2 radical gastrectomy. World J Gastroenterol, 2015, 21(5):1606-1613.
19. Zhang GT, Zhang XD. A hand-assisted laparoscopic distal gastrectomy can be an effective way in obese patients. Surg Laparosc Endosc Percutan Tech, 2013, 23(2):145-148.
20. Gong JQ, Cao YK, Wang YH, et al. Three-step hand-assisted laparoscopic D2 radical gastrectomy for Chinese obese patients:a highly efficient and feasible surgical approach. J Cancer, 2015, 6(2):120-127.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Comparative study of Short-Term Outcomes of D2 Radical Distal Gastrectomy for Gastric Cancer Between Hand Assisted Laparoscopic and Traditonal Open Techniques

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