Comparison Of Lymph Nodes Dissection Rate Between Laparoscopic With Open Radical Gastrectomy For Gastric Cancer

Objective:By compared the number of dissected lymph nodes under different clinical and pathological factors between laparoscopic radical gastrectomy for gastric cancer and conventional open radical gastrectomy, and investigate the effection of lymph node dissection in laparoscopic radical gastrectomy, then provide the basis for the rationality and feasibility for laparoscopic radical gastrectomy. Simultaneous analyse the relationship between the number of dissected lymph node and clinical pathological factors under laparoscopic radical gastrectomy for gastric cancer. Compared to conventional open surgery what are the advantages and disadvantages of laparoscopic radical gastrectomy for gastric cancer.Methods:Retrospectively analyse clinical data of 50 cases laparoscopic gastric cancer surgery and 43 cases conventional open radical surgery in The Third Affiliated Hospital of Nanchang University from June 2006 to May 2010, respectively collected sex, age, preoperative related check (gastroscopy, B ultrasound, CT), the ways of operation, postoperative pathological findings and other relevant information, all of the specimens were routinely dissected after the operations, respectively record the size of tumor, location, and Borrmann types, dissected lymph nodes from the specimens in groups and counted the number, according to pathology reports respectively record the metastasis number of lymph nodes cut from each groups, tumor histological type and depth of invasion, the results were statistically analyzed.Results:The total number of lymph nodes dissected in 50 cases laparoscopic radical gastrectomy for gastric cancer was 1388 with an average of 27.76±7.46 each case,detected metastatic lymph nodes 533, the metastatic rate was 38.40%;The total number of lymph nodes dissected in 43 cases open radical gastrectomy for gastric cancer was 1229 with an average of 28.58±5.99 each case, detected metastatic lymph nodes 458, the metastatic rate was 37.27%. The average of lymph nodes dissection was not significant different between the laparoscopic group and open group under the same clinical and pathological factors,such as depth of gastric wall invaded, tumor size, tumor gross types, pathologic types, differentiation degree and location of tumor; All of the laparoscopic group and open group was according to the following results:The average lymph nodes dissected from infiltrate types of tumor(BorrmannIII+IV)was significantly higher than limition types(Borrmann I+11) (P<0.05). The average of lymph nodes resection which tumor located at upper and middle stomach was higher than lower stomach significantly (p<0.05).The tumors has not invaded the serosa layer,that the average of lymph nodes dissection was significantly lower than which invaded the serosa layer(P<0.05). With the increasing of tumor size(diameter< 4cm, diameter 4～8cm, diameter≥8cm),the average of lymph nodes clearance will be also significant increasing(P<0.05). The average lymph nodes dissection of undifferentiated degree tumor was significantly higher than that in the differentiated ones(P<0.05).Conclusion:1,When gastric cancer has the similar clinical and pathologic factors such as depth of invasion,growth location,gross type,tumor size,pathologic type and degree of differentiation, the rate of lymph node dissection was no significant difference between laparoscopic with open radical gastrectomy for gastric cancer, thus laparoscopic radical gastrectomy for gastric cancer can attain the same effection in lymph nodes dissection with open radical gastrectomy for gastric.2,With the enlarge role of laparoscopic,for the regional lymph node dissection, laparoscopic radical operation for gastric cancer compared with open surgery has certain advantages.