Early Amputation Duodenal Radical Application In Laparoscopic Total Gastrectomy

ObjectiveThrough laparoscopic total gastrectomy+D2lymphadenectomy two surgicalmethods and open total gastrectomy+D2lymphadenectomy compare the clinicalefficacy of surgery to discuss the safety and feasibility of two full stomachlaparoscopic resection and slightly superior two surgical methods.MethodsCollected clinical data radical total gastrectomy109patientsfrom January2012to January2014at the Cancer Hospital of Zhengzhou University, includinglaparoscopic gastrectomy group of57cases, early cut duodenum group (A)17cases，conventional laparoscopic group (group B)40cases and open surgery group(group C)52cases. All statistics were first surgery patients. Postoperative lymphnode dissection, the operation time, blood loss, postoperative complications,postoperative exhaust defecation, hospitalization time and other indicators wereanalyzed retrospectively.ResultsThree groups had no perioperative deaths, A group: The mean operative timewas (151.1±43.7) min, blood loss (67.7±45.9) mL; average number of lymph nodedissection (23.1±6.5) pieces, the number of positive lymph nodes (3.0±2.6) pieces; postoperative discharge time (2.9±0.8) days, the average length of stay (11.5±2.6)days. Group B: The mean operation time was (180.0±27.5) min, blood loss (90.0±35.9) mL; average number of lymph node dissection (23.4±6.3) pieces, the numberof positive lymph nodes (2.3±2.3) pieces; after row air time (3.4±1.0) days, theaverage length of stay (11.8±3.2) days. Group C: The mean operation time was(126.2±15.8) min, blood loss (197.3±137.7) mL; average number of lymph nodedissection (21.1±6.0) pieces, the number of positive lymph nodes (3.3±5.6) pieces;after row air time (4.0±0.8) days, the average length of stay (15.9±3.1) days.3groups of postoperative complications rate was （2/17,11.8%）in group A, group B（5/40,12.5%）, group C （7/52,13.4%）.ConclusionsBy contrast with traditional laparoscopic surgery and traditional open surgery,prove laparoscopic radical gastrectomy in early cut of the surgical duodenal is safetyand rationality,and this approach of laparoscopic surgery is worthy promoting.