Clinical Comparative Study Of No.12 Groups Of Laparoscopic Lymph Node Dissection For Advanced Gastric Cancer

Objective: To evaluate the clinical value of laparoscopic radical gastrectomy in the treatment of advanced gastric cancer by comparing the difference of the NO.12 lymph node dissection of advanced gastric cancer in two different methods of laparoscopy and laparotomy.Methods: The clinical data of D2 radical gastrectomy for advanced gastric cancer in Department of general surgery of Handan Central Hospital from September 2015 to January 2017 were analyzed retrospectively.72 patients underwent laparoscopic radical gastrectomy(laparoscopic group n=72)and 114 patients underwent open abdominal radical gastrectomy(open abdominal group n=114).The operation time(min),intraoperative bleeding volume(ML)and The difference of the NO.12 lymph node number(pieces),the positive number of lymph node dissection in the NO.12 lymph node,the postoperative exhaust time(day),the number of days after the operation(day)and the incidence of complications(%)were observed in the 2 groups..Results: 2 groups of patients were successfully completed surgery,discharged after discharge standard,no perioperative death.The comparison of the clinical and postoperative indexes: the average operating time in the laparoscopic group was(253.1 + 22.8)min,the open group was(226.1 + 26.4)min,the average bleeding volume in the laparoscopy group was(143.4 + 15.8)ml,the open group was(212.5 + 15.5)ml,and the number of lymph node dissection in the No.12 group was(3.95 + 1.1),and the laparotomy group was(4.55 + 0.8),and the positive number of No.12 lymph nodes: laparoscopy group(1.55 + 0.8),open group(1.60 + 0.8),postoperative anus first exhaust time: laparoscopy group(3.25 + 0.8)days,open group:(5 + 1.1)days;average postoperative hospital time,laparoscopy group:(10.45 + 1)days,open group:(15.5 + 1.5)days;total hospitalization expenses: laparoscope group(4.43±1.28)ten thousand Yuan,open group(3.76±1.04)ten thousand Yuan.The operation time of the laparoscopy group was relatively long compared with the operation time in the open group(P < 0.05);the difference between the 2 groups was not statistically significant of the number of lymph node dissection in the No.12 group(P > 0.05),and the difference between the 2 groups was not statistically significant of the positive number of No.12 lymph nodes(P > 0.05),and the amount of bleeding in the laparoscopic group was relatively less than that in the open group(P < 0.05).The recovery time of the laparoscopic group was better than that in the open group(P < 0.05),and the incidence of complications in the 2 groups was not statistically significant(P > 0.05),and the total hospitalization cost in the laparoscopy group was slightly higher than that in the open group(P < 0.05).Conclusion:(1)laparoscopic D2 radical gastrectomy for gastric cancer is safe and feasible for advanced gastric cancer.(2)laparoscopic radical gastrectomy for NO.12 of lymph nodes can achieve the same effect as open surgery.(3)laparoscopic radical gastrectomy for advanced gastric cancer has the same effect as radical gastrectomy for advanced gastric cancer,with less bleeding and short recovery time,but laparoscopic radical gastrectomy for gastric cancer is relatively long,and the cost of hospitalization is relatively high.