| Objective: To evaluate the feasibility and safety of laparoscopy-assisted D2gastrectomy for gastric cancer patients with COPD in stages I and II.Methods: This was a retrospective cohort study of patients with gastric cancer andCOPD who underwent gastrectomy from January2010to December2011in the firstaffliliated hospital of Fujian medical university.The outcomes and complicationsbetween laparoscopy and open gastrectomy group were analyzed.Results: There were112patients enrolled in this study.Among them,44patientsreceived laparoscopic gastrectomy(LG group) and68underwent opengastrectomy(OG group). The PetCO2and PaCO2during surgery were statisticallydifferent between the LG and OG group(P<0.05).No significant differences wereobserved in operative time and cumulative oxygen inhalation time aftersurgery(P>0.05).In the aspect of intraoperative blood loss,rate of blood transfusion,oxygen saturation on the first postoperative day,the number of analgesic aftersurgery,first flatus,food recovery time,ambulation time, postoperative hospitalstays,The LG group showed distinctive advantage than the OG group with thesignificant difference statistically(P<0.05).There were no significant differences inincidence of postoperative pulmonary complications between the LG (27.3%) and OG(29.4%) groups(P=0.807). The rate of the other complications in LG group and OGgroup were13.6%and14.7%,and the difference was not significant (P=0.874). Andthere were no significant differences in proximal and distal margin of tumor and thenumber of resected lymph nodes between two groups(P<0.05). Conclusion: The CO2pneumoperitoneum in laparoscopy-assisted D2gastrectomyfor gastric cancer may have a negative impact on respiratory function of patients withCOPD.However,the minimal invasion of laparoscopic surgery can reduce the affect ofthe CO2pneumoperitoneum and promote the recovery of postoperative pulmonaryfunction. LG can be performed safely for patients with gastric cancer and COPD instage â… and â…¡. |
PDF Full Text Request