Clinical efficacy analysis of laparoscopy-assisted radical gastrectomy for 1380 patients with gastric cancer

Abstract

To explore the technical feasibility, safety, and clinical efficacy of laparoscopy assisted radical gastrectomy(LAG) for patients with gastric cancer. Clinical data of 1380 patients with gastric cancer who received LAG from May 2007 to April 2012 were analyzed retrospectively. LAG was successfully carried out in 1363 patients, and 17 patients(1.2%) were converted to open surgery. The mean operation time, blood loss, number of dissected lymph nodes were(196.2±59.2) minutes, (79.7±115.8) ml, and 30.1±11.0, respectively. The average time to ground activities, time to flatus, time to fluid diet, and length of hospital stay were(2.4±1.0) days, (3.3±1.2) days, (4.2±1.6) days, and (12.4±8.5) days, respectively. The postoperative morbidity was 12.1% and the mortality was 0.4%. According to Simple Scatter analysis, the number of surgical cases(surgeons' experience) was negatively related with the rate of converted to open surgery and operation time, but positively with number of dissected lymph nodes. A total of 1332 patients were followed up for 2-51 months(median 19 months), and the 3-year survival rate was 71.0%, the 3-year survival rates in stage I(, stage II(, and stage III( were 94.5%, 83.9%, and 56.7%, respectively. Laparoscopy assisted radical gastrectomy is a safe and feasible procedure with better clinical efficacy for gastric cancer. With improvement in the surgical technology, the conversion rate and operation time decrease, and the number of dissected lymph nodes will increase.