Clinical Observation Of Laparoscopy-assisted Gastrectomy For Gastric Cancer

OBJECTIVE: To study the short-term outcome of laparoscopy-assisted gastrectomy for gastric cancer.METHODS: 27 cases of laparoscopy-assisted gastrectomy for gastric cancer were operated in our department from 2004.9 to 2007.1, including 8 cases of total gastrectomy, 18 cases of partial gastrectomy, and 1 case turning to open procedure. The operative time, blood loss, hospital stay, anesthetic agent usage and lymph node harvested of those 26 cases accomplished in laparoscope were compared with those of 30 cases of open radical resection of gastric cancer retrospectively. RESULTS: There were 6 cases of early gastric cancer and 20 advanced cancer in the laparoscopy-assisted group, compared with 8 cases of early gastric cancer and 22 advanced cancer in the open group. For the patients underwent total gastrectomy, the mean operative time was 6.2h, mean blood loss was 250ml, mean hospital stay was 18d, mean anesthetic agent usage was 2 times and the mean number of lymph node harvested was 28in the laparoscopy-assisted group. These data were 4h, 394ml, 23d, 4 times, and 29 in the open group. For the patients underwent partial gastrectomy, these data were 3.6h, 259ml, 17d, 1.6 times and 20 in the laparoscopy-assisted group, compared with 3.25h, 418ml, 22d, 3.9 times and 23 in the open group.CONCLUSION: For the patients underwent partial gastrectomy, the blood loss, hospital stay and anesthetic agent usage of the laparoscopy-assisted group were less than those of the open group, with statistical difference, while the operative time and the number of lymph node harvested were not statistically different between these two groups. For the patients underwent total gastrectomy, the anesthetic agent usage of the laparoscopy-assisted group was less than that of the open group, while the operative time was longer than that of open group, both with statistical difference. The blood loss, hospital stay and number of lymph node were not statistically different. Laparoscopy-assisted gastrecomy for gastric cancer is a new treatment option worthy of clinical research, especially for partial gastrectomy. A prospective randomized multicenter study is needed to evaluate the long-term outcome of this procedure. From a perspective view, this procedure will play an important role in the treatment of gastric cancer with the improvement of operative technique, accumulation of experience and the new operation instrument.