Short-term Efficacy And Analysis Of Laparoscopic Surgery And Open Surgery In Treatment Of Advanced Gastric Cancer

Gastric cancer is one of the common malignant tumors in China,90%ofpatients diagnosed advanced gastric cancer when they hadsymptom.Although the comprehensive treatment of gastric cancer has beengreatly developed, but surgery is still the best way for patients with gastriccancer.As an emerging discipline,minimally invasive surgery is rapidlydeveloping in the past20years. Laparoscopic techniques,as an mainlyrepresenting minimally invasive surgery,has been rapidly development andaffected the surgeon’s ideas and surgical methods and opened up anotherchapter for surgical treatment.Since1994,Kitano et al first reportedlaparoscopic radical gastrectomy.Because it has Significant minimallyinvasive advantages relative to the traditional radical gastrectomy, and beenable to treat patients with gastric cancer with lymph node metastasis risk,and thus been gradually carried out worldwide.ObjectiveTo explore Short-term efficacy of laparoscopic surgery and open surgerytreatment of advanced gastric cancer, and carry on the contrast and analysis.MethodsRetrospective analysis of77cases of stage Ⅰ, Ⅱpatients with gastriccancer,hospitalized in Dalian Medical University,Dalian Central Hospitalfrom January2010to October2012;39cases of laparoscopic-assistedradical gastrectomy;38underwent open radical gastrectomy.Observingsurgery-related indicators in two groups, which included in incision length,operative time, blood loss intraoperative, total number of clearing lymphnodes,anal exhaust time,start eating time,postoperative hospitalstay,postoperative abdominal drainage,the number WBC in blood in postoperative acute stage of reaction,postoperative serum albumin and totalprotein,postoperative recovery of immune function and postoperativecomplications.Statistical analysis uses the SPSS17.0statisticalpackage.Among them, the count data is expressed as the number of casesand percentage(%),using the chi-square test;measurement data is expressedas mean±standard deviation(±s).ResultsThe laparoscopic group incision length was significantly less than thelaparotomy group(P<0.01).The blood loss in laparoscopic group is less thanin laparotomy group(P<0.05).The comparison of operative time and thenumber of lymph node dissection in laparoscopic group and open group isnot statistically significant(P>0.05).Anal exhaust time and start eating timein laparoscopic group is earlier than in the laparotomy group(P<0.05),andpostoperative hospital stay is less than laparotomy group(P<0.05).Postoperative1,3,7days abdominal drainage fluid in Laparoscopic group andopen group is not statistically significant(P>0.05).The comparison of thenumber WBC in blood in postoperative acute stage of reaction: the numberof blood WBC in postoperative1,3,7days in the laparoscopic group is lessthan the open surgery group,is more close to the physiological normal valueand has statistically significant (P<0.05).The comparison of postoperativeserum albumin and total protein in two groups:the serum album and totalprotein values in postoperative1,3days in the laparoscopic group is higherthan the laparotomy group,is more close to the the physiological normalvalue and has statistically significant(P<0.05);The comparison of the serumalbum and total protein values in postoperative7day in two groups is notstatistically significant(P>0.05). The comparison of postoperative immunefunction in two groups:1d postoperative peripheral blood CD4+(%),CD8+(%), CD4+/CD8+than before surgery were significantly lower in twogroups(P <0.05),but there was no significant difference between the twogroups(P>0.05).Patients after the index laparotomy group weresignificantly lower than3,7d laparoscopic group (P <0.05).ConclusionLaparoscopic-assisted distal gastrectomy is safe and feasible,and can achieve the curative effect of open gastric radical mastectomy and has theadvantage of postoperative quick recovery,small influence of immunefunction and has well application prospects.