Efficacy analysis of laparoscopy-assisted pylorus-vagus nerve preserving gastrectomy in the treatment of early middle gastric cancer

Abstract

To compare the efficacy and safety of laparoscopy-assisted pylorus-vagus nerve preserving gastrectomy (LAPPG) and laparoscopy-assisted distal gastrectomy (LADG) in order to evaluate the feasibility of LAPPG in the treatment of early middle gastric cancer. Clinical and follow-up data of 60 patients with early middle gastric cancer undergoing laparoscopic operation in The First Affiliated Hospital of Dalian Medical University from September 2003 to July 2010 were analyzed retrospectively, including 35 patients with LAPPG and 25 with LADG. Operation time, blood loss, postoperative complications, postoperative nutritional status and long-term survival were compared between two groups. There were no significant differences in baseline information between the two groups. Distal resection margin distance of LAPPG group was significantly shorter than that of LADG group [(2.64±1.29) cm vs. (4.66±2.01) cm, P=0.001], while operative time, blood loss, and number of harvested lymph node were not significantly different between the two groups (all P>0.05). In LAPPG group, ratio of delayed gastric emptying was significantly higher [28.6%(10/35) vs. 8.0%(2/25), P=0.046] and ratio of acid reflux was significantly lower [0 vs. 20.0%(5/25), P=0.038] as compared to LADG group, while postoperative complications, body weight and serum albumin level were not significantly different between the two groups (all P>0.05). Postoperative overall 5-year survival rate was 91.1% and 90.3% in LAPPG and LADG group respectively without significant difference (P=0.704). LAPPG can effectively control the velocity of postoperative gastric emptying and decrease gastric reflux without affecting oncologic efficacy, which is a good choice in the treatment of early middle gastric cancer.