title: [Efficacy evaluation of laparoscopic D2 radical gastrectomy in gastric neuroendocrine carcinoma].
abstract: OBJECTIVE
  To explore the feasibility and efficacy of laparoscopic D2 radical gastrectomy in patients with gastric neuroendocrine carcinoma (GNEC).
  
  
  METHODS
  Clinical data of 84 patients with GNEC undergoing laparoscopic D2 radical gastrectomy in Union Hospital from January 2006 to December 2012 were analyzed respectively. Among these patients, 44 cases underwent laparoscopic D2 gastrectomy (LAG group) and 40 cases underwent open gastrectomy (OG group). The short- and long-term outcomes, 3-year survival and recurrence-free survival were compared between two groups.
  
  
  RESULTS
  The LAG group and OG group did not differ significantly in terms of clinicopathologic characteristics. All the patients completed operations successfully and no patients in the LAG group ware converted to laparotomy. The operative time was similar (P>0.05). As compared to OG group, LAG group had less intra-operative blood loss [(85±21) ml vs. (192±89) ml, P=0.003], lower ratio of transfusion [2.3%(1/44) vs. 15.0%(6/40), P=0.048], shorter time to ambulation after surgery [(2.5±1.1) days vs. (3.5±1.1) days, P=0.001], faster postoperative gastrointestinal function recovery [(2.9±1.1) days vs. (5.1±1.0) days, P=0.001], shorter time to resume soft diet [(4.1±1.2) days vs. (5.7±1.3) days, P=0.001] and shorter postoperative hospital stay [(12.0±3.4) days vs. (15.0±5.5) days, P=0.002]. No significant difference was observed in average dissected lymph node number between LAG and OG group (35.0±16.4 vs. 31.6±12.1, P=0.204). Morbidity of postoperative complication of LAG group and OG group was 11.4%(5/44) and 17.5%(7/40) respectively (P=0.422). The overall 3-year survival rate was 54.0% for all the patients, while 3-year survival rate was 56.3% in LAG group and 51.4 % in OG group (P=0.478). In addition, there was no significant difference in recurrence-free survival between the two group (33.0 months vs. 31.5 months, P=0.703).
  
  
  CONCLUSIONS
  Compared with open gastrectomy, laparoscopic D2 radical gastrectomy has the advantages of faster recovery and less blood loss, and similar short-term and long-term outcomes in treatment of patients with GNEC, thus it is a safe and feasible treatment for GNEC.
authors.forename: Jianwei
authors.initials: J
authors.lastname: Xie
authors.affiliation: Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China. hcmlr2002@163.com.
authors.forename: Changming
authors.initials: C
authors.lastname: Huang
authors.forename: Chaohui
authors.initials: C
authors.lastname: Zheng
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.forename: Jiabin
authors.initials: J
authors.lastname: Wang
authors.forename: Jianxian
authors.initials: J
authors.lastname: Lin
authors.forename: Jun
authors.initials: J
authors.lastname: Lu
authors.forename: Qiyue
authors.initials: Q
authors.lastname: Chen
authors.forename: Longlong
authors.initials: L
authors.lastname: Cao
authors.forename: Mi
authors.initials: M
authors.lastname: Lin
authors.forename: Ruhong
authors.initials: R
authors.lastname: Tu
mesh_terms: D016063:Blood Loss, Surgical; D018278:Carcinoma, Neuroendocrine / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D007902:Length of Stay; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D011184:Postoperative Period; D013274:Stomach Neoplasms / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome