[Efficiency of laparoscopic D2 radical gastrectomy in gastric cancer: experiences of 218 patients].
OBJECTIVE
To explore the feasibility and efficacy of laparoscopic D2 radical gastrectomy in patients with gastric cancer.


METHODS
The clinical data of 529 patients with gastric cancer underwent D2 radical resection from January 2007 to March 2009 were analyzed retrospectively. Among the patients, 218 cases underwent laparoscopic D2 gastrectomy (LAG group) and 311 cases received open gastrectomy (OG group). The patients' operation, number of retrieved lymph nodes, recovery, postoperative morbidity and mortality were compared between the two groups.


RESULTS
The operative time in LAG group was (237 +/- 42) min, and was significantly longer than that in OG group [(229 +/- 42) min, P < 0.05]. However, the mean blood loss [(81 +/- 100) ml vs. (171 +/- 211) ml], number of patients needed blood transfusion (7 vs. 44 cases), first flatus time [(4.1 +/- 2.3) d vs. (5.0 +/- 1.4) d], time to resume soft diet [(4.5 +/- 2.2) d vs. (5.5 +/- 1.4) d] and postoperative hospital stay [(12 +/- 4) d vs. (14 +/- 4) d] in the two groups were all different statistically (P < 0.05), and all were better in LAG group. In LAG group, the operative time of patients with total gastrectomy was (250 +/- 46) min, and was significantly longer than that with distal gastrectomy (228 +/- 37) min (P < 0.05), but there was no significant differences in other aspects of patients' recovery between the two operation types. The postoperative morbidity of LAG group and OG group were 11.9% and 19.0%, respectively (P < 0.05). For all patients, the mean number of retrieved lymph nodes was (29 +/- 10) and the median number was 28. The mean number of retrieved lymph nodes was not significantly different between the two groups [(28 +/- 10) in LAG group vs. (29 +/- 9) in OG group, P > 0.05]. Thirteen patients (6.0%) converted to open surgery in LAG group.


CONCLUSIONS
Laparoscopic D2 radical gastrectomy is a safe and feasible procedure with quick recovery, and it is comparable with open gastrectomy in lymph node dissection.
Wang
Jia-bin
JB
Department of Surgical Oncology, the Affiliated Union Hospital, Fujian Medical University, Fuzhou 350001, China.
Huang
Chang-ming
CM
Zheng
Chao-hui
CH
Li
Ping
P
Xie
Jian-wei
JW
Lin
Bi-juan
BJ
Lu
Hui-shan
HS
D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome