The Research Of Short-term Efficacy And Safety Between Laparoscopic Assisted And Open Gastrectomy Following Neoadjuvant Therapy For Advanced Gastric Cancer

【Objective】 To comparatively analyze the degree of trauma, operation result and recovery condition after operation between laparoscopic and open surgery, and explore the advantage of laparoscopic surgery following neoadjuvant therapy(neoadjuvant chemotherapy, neoadjuvant chemoradiotherapy).【Methods】Retrospectively comparative analyzed laparoscopic and open gastrectomy in operation time, intraoperative blood loss, the amount of lymph node dissection, postoperative time of keeping gastric canal, postoperative hospital stay, WBC and ALB of first postoperative day, postoperative complications in 211 patients from august 2010 to december 2015. The 211 patients include 193 cases of patients with neoadjuvant chemotherapy and 18 cases of patients with neoadjuvant chemoradiotherapy. All the patients were divided into 55 cases of laparoscopic assisted gastrectomy group,156 cases of open gastrectomy group.[Results] Operation time, intraoperative blood loss, the amount of lymph node dissection, WBC and ALB of first postoperative day, postoperative complications were not obvious difference between laparoscopic and open gastrectomy following neoadjuvant therapy(P>0.05). But intraoperative blood loss[(166.5± 183.1)ml VS (233.1 ±185.5)ml], differences are statistically significant(P=0.022). Postoperative time of keeping gastric canal[(5.9 ± 4.2)d VS (7.2 ± 3.4)d], differences are statistically significant(P=0.029).Postoperative hospital stay[(11.0 ± 4.2)d VS (14.1±8.4)d], differences are statistically significant(P=0.008). The total complications rate was 15.6% after neoadjuvant therapy without serious fatal complications.【 Conclusion 】 Fisrt, radical gastrectomy was safe after neoadjuvant therapy of gastric cancer without increasing the incidence of serious complications. Second, laparoscopic assisted gastrectomy had an advantage over open gastrectomy in the intraoperative blood loss, postoperative hospital stay, postoperative intestinal function recovery time after neoadjuvant therapy and had same effect of radical resection comparision of open gastrectomy. Third, neoadjuvant therapy combined with laparoscopic surgery was safe and effective, the treatment mode was worth to continue study by expanding the sample capacity.