Comparison of the clinical effect of laparoscopic and laparotomy D2 gastric cancer radical on advanced gastric cancer

Abstract

Objective To evaluate the clinical value of laparoscopic and open radical gastrectomy for gastric cancer in advanced stage(D2). Methods A retrospective analysis was conducted in 100 patients with advanced gastric cancer who underwent surgical treatment. The patients were randomly divided into laparotomy group (n=44) and laparoscopic group (n=56). The laparotomy group was treated with D2 radical operation for advanced gastric cancer by the conventional laparotomy, while the laparoscopic group underwent laparoscopic radical resection of advanced gastric cancer with D2. The surgery related indicators, as well as intraoperative and postoperative complications etc. were compared between the two groups. All patients were followed up for 24 months. The recurrence, metastasis and mortality of the patients in the two groups were compared. Results The operation time and the amount of bleeding of the laparoscopic group were less than those of the laparotomy group (P=0.020, 0.001). The postoperative intestinal function recovery and hospitalization time of the laparoscopic group were shorter than those of the laparotomy group (P=0.020, 0.001). There was no significant difference between the two groups in the number of lymph node dissection (P=0.650). Various complications occurred in the two groups, such as bleeding, spleen injury, vascular injury of colon injury and pancreatic injury, but the difference between the two groups was not statistically significant (P=1.000, 0.570, 1.000, 1.000). There was no significant differences between the two groups in pancreatic fistula, anastomotic leakage, remnant stomach weakness and anastomotic bleeding (P=0.020, 0.005, 1.000, 1.000, 0.570). After 24 months of follow-up, there was no significant difference in recurrence, metastasis and mortality between the two groups (P=0.450, 0.290, 0.530). Conclusion Endoscopic surgery for D2 resection in the treatment of advanced gastric cancer has advantages, such as less trauma, rapid recovery and so on, can reduce the occurrence of postoperative complications. Key words: Stomach neoplasms; Laparoscopy; Digestive system surgical procedures