Comparative Study Of Laparoscopic Pylorus- And Vagus-preserving Gastrectomy Versus Pylorus- And Vagus-preserving Gastrectomy For Early Gastric Cancer

Objective:To investigate and evaluate the feasibility and safety of laparoscopic pylorus-and vagus-preserving gastrectomy by comparing it's short-term clinical effect with pylorus-and vagus-preserving gastrectomy in treatment for early gastric body cancer.Methods:A total of 24 patients with early gastric cancer undergoing laparoscopic pylorus-and vagus-preserving gastrectomy(LAPPG)or pylorus-and vagus-preserving gastrectomy(PPG)in the department of gastrointestinal surgery,First affiliated Hospital of Dalian Medical College,between January 2010 and January 2016 were retrospectively reviewed and analyzed.Which confirmed for gastric cancer according to biopsy pathology preoperative gastroscopy and CT positioning lesions located in gastric body,lesion diameter less than 5 cm,edge of tumor from the pylorus is greater than 4 cm,eliminate local infiltration,local lymph node metastasis and distant metastasis,postoperative paraffin pathology confirmed lesions to the mucosa and submucosa.Patients were divided into laparoscopic group(LAPPG,n=13)and open group(PPG,n=11).Length of incision,operative time,blood loss,the number of resection lymph node,the distance of distal and proximal incisal margin,time to passage of flatus,postoperative hospital stay,complications and pathologic findings were compared between the two groups.Results:The age,gender,BMI,ASA classification,types of differentiation,lymph node metastasis and tumor infiltration depth of two groups have no obvious difference.Compared with PPG group,the length of the incision of LAPPG group was significantly shorter,blood loss was less,the complications were fewer,operation time was longer,the distance from cancer focus to proximal and distal incision margins between the two groups was not statistically significant,the number of resection lymph nodes was similar,time to passage of flatus was shorter,postoperative hospital stay was shorter.Conclusions:Laparoscopic pylorus-and vagus-preserving gastrectomy was a safe,feasible,effective and less invasive surgery for early gastric cancer.