The Clinical Comparative Study Of Laparoscopic-assisted And Open Radical Distal Gastrectomy With D2 Lymphadenectomy

Objective:Through the comparison of the relevant indicators and followed-up results between laparoscopic-assisted and traditional open radical distal gastrectomy with D2 lymph node dissection, to explore the advantages and disadvantages about the treatment of laparoscopic-assisted gastrectomy.Methods:The male patients' data were collected in our department as the investigations, they were all suffered from distal gastric cancer during 2008 and 2009, All the patients were successfully underwent the laparoscopic-assisted and open radical distal gastrectomy with D2 lymph node dissection by the same surgeons.1,The patients' age, preoperative albumin, hemoglobin, preoperative routine examinations, tumor position and the depth of invasion were collected to evaluate the general situation of patients before the operation.2,The operation time,blood loss, the number of lymph node dissection, incision length, the time of gastrointestional function recovery, postoperative hospital stay, incision healing and the postoperative complications were collected, and then, all of the data were dealed with statistical analysis. According to postoperative pathologic examination to determine the histological type of cancer, clinical stage and whether there were cancer cells on the margin of specimens from top to bottom.3,All the patients were regular followed-up to know the patients'quality of life and distant metastasis, to understand the short-term effect after discharged from hospital.Results:1,Based on the preoperative assessment of the patients' general situation and the results of examinations:Patients'preoperative physical conditions in two groups were not significantly different (P> 0.05); They were all distal gastric cancer, without distant organ metastasis.2,By comparison, the operation time of laparoscopic group was longer than the open group, the difference was statistically significant;the number of the lymph node was not significant different. The blood loss, incision length, postoperative anal exhaust time, postoperative hospital stay and wound healing were all superior to the laparotomy group, and the difference was statistically significant (P<0.05). The postoperative pulmonary infection in the 2 groups were no significant different(P> 0.05). According to the postoperative pathologic results:both groups reached the radical resection.3,Regular follow-up, all patients were alive and were not found to have distant metastasis.Conclusion: 1,Laparoscopic-assisted radical gastrectomy with D2 lymphadenectomy can achieve the same radical effects with open operation, it is proved safe and feasible.2,Laparoscopic-assisted radical gastrectomy with D2 lymphadenectomy has obvious advantages, such as smaller surgical trauma, less blood loss, quicker postoperative recovery and shorter hospital stay. Serious complications, such as postoperative intra-abdominal bleeding, and anastomotic leakage, had not been occurred.3,From the regular following-up results of all the patients, there were no significant difference in the survival, no case of distant metastasis occurred after laparoscopic gastrectomy, and it is equal with open surgery in short-term outcomes. The long-term outcome needs further study.