[Laparoscopy-assisted D2 total gastrectomy in advanced gastric cancer].
OBJECTIVE
To investigate the efficacy and advantages of laparoscopy-assisted total gastrectomy (LATG) with D2 dissection of lymph nodes versus conventional open D2 total gastrectomy (OTG) in advanced gastric cancer.


METHODS
One hundred and twenty-five patients with advanced gastric cancer in the middle or upper third of the stomach were operated on from July 2005 to March 2007. Of the patients, 59 cases received LATG and 66 OTG with D2 lymph nodes dissection. Clinical data were recorded and compared between the two groups.


RESULTS
No patient in the LATG group converted to conventional operation with laparotomy. No operation mortality and no severe morbidity occurred in LATG group. As compared with OTG group, in LATG group operation time was longer [(330 +/- 71) min vs. (261 +/- 54) min, P =0.005] in LATG group, but with similar number of lymph node retrieval (36 +/- 13 vs. 34 +/- 16, P =0.450), less operation blood loss [(175 +/- 101) ml vs. (359 +/- 210) ml, P =0.003], earlier recovery of bowel activity (P = 0.015), and a shorter duration of fever after operation (P = 0.024).


CONCLUSIONS
LATG with D2 lymph node dissection in advanced gastric cancer is safe and technically feasible with better operative access and visual field, less operation blood loss and earlier recovery.
Department of General Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China. dujjm@163.com
Jian-Jun
JJ
Du
Wei-Zhong
WZ
Wang
Ji-Peng
JP
Li
Jian-Yong
JY
Zheng
Gang
G
Ji
Yong-Qi
YQ
Li
Xiao-Nan
XN
Liu
Dong-Li
DL
Chen
Jin-Xiang
JX
Cheng
Zhi-Qing
ZQ
Gao
Ke-Feng
KF
Dou
D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome