| Objective:To explore the short-term and long-term efficacy and safety of laparoscopic-assisted radical gastrectomy and laparotomy in the treatment of advanced gastric cancer,in order to provide suggestions or guidance for the selection of clinical treatment options for patients with advanced gastric cancer.Methods:124 patients with advanced gastric cancer admitted to general surgery of the First Affiliated Hospital of Taishan Medical College of Shandong Province from January 2012 to December 2013 were selected as the study subjects.Among them,60 patients underwent open surgery(open group)and 64 patients underwent laparoscopic-assisted radical surgery(laparoscopic group).The operation conditions,postoperative rehabilitation,complications,quality of life before and after intervention,and 5-year absence were compared between the two groups.Survival rate,5-year recurrence rate.Results:There were insignificant differences in gender,age,TNM stage,tumor diameter,tumor location,body mass(BMI),number of lymph node dissection and surgical methods between the two groups(P > 0.05).In laparoscopic group,the exhaust time,the time to resume normal eating,the time to get out of bed and stay in hospital were shorter than those in open group(P < 0.05),while the operation time was longer than that in open group(P < 0.05),while the amount of bleeding during operation was less than that in open group(P < 0.05),and the visual analogue score(VAS)after operation was lower than that in open group(P < 0.05).The incidences of incision infection,pulmonary infection,duodenal stump fistula,intestinal obstruction and wound dehiscence in laparoscopic group were lower than those in open group(P < 0.05).The total score of quality of life and the scores of each dimension in the observation group were higher than those in the control group 6 months after operation(P < 0.05).All excision margins of the two groups were negative,and there was no residual tumor cells.There was no significant difference in median survival time,5-year disease-free survival rate and recurrence rate between the two groups after 5-year follow-up(P > 0.05).Conclusion:Laparoscopic-assisted and open radical gastrectomy for advanced gastric cancer can achieve similar clinical efficacy,but the short-term efficacy of laparoscopic surgery,such as low incidence of recent complications,rapid recovery after surgery,is more accurate,and laparoscopic treatment of advanced gastric cancer can improve the quality of life of patients after surgery.Laparoscopic-assisted radical gastrectomy is a safe and feasible surgical treatment for advanced gastric cancer. |
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