laparoscopically assisted distal gastrectomy 1

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1 DOI /j. cnki. fqjwkzz ? laparoscopically assisted distal gastrectomy LADG laparoscopically assisted total gastrectomy LATG LADG LATG R A Comparative analysis of short-term outcomes between laparoscopy-assisted gastrectomy and open gastrectomy for gastric cancer HUANG Xin LIU Shao-zhuang YU Fei et al. Department of General Surgery Qilu Hospital of Shandong University Jinan China Abstract Objective To compare the efficacy of laparoscopy-assisted gastrectomy and open gastrectomy for gastric cancer and analyze the feasibility safety and effectiveness of laparoscopy-assisted gastrectomy. Methods This is a retrospective analysis of clinical data of patients who underwent gastrectomy from Jul to Feb patients underwent open distal gastrectomy 27 patients underwent laparoscopically assisted distal gastrectomy 20 patients received open total gastrectomy and 24 patients received laparoscopically assisted total gastrectomy. The operation time blood loss postoperative hospital stay postoperative complications and so on were compared among the 4 groups. Results When performed laparoscopically distal and total gastrectomy both required longer operation time but resulted in significantly reduced blood loss and length of postoperative hospital stay and had faster gastrointestinal function recovery and removal of drainage tube. Conclusions Laparoscopy-assisted gastrectomy for gastric cancer is a safe reliable and effective procedure which has the advantage of mini incision little blood loss and fast recovery. It deserves to be recommended in the clinical application. Key words Stomach neoplasms Laparoscopy Laparotomy Comparative effectiveness research laparoscopically assisted distal gastrectomy 1 LADG D ? husanyuan1962@ hotmail. com

2 21 1 ODG 21 LADG open total gastrectomy OTG OTG 24 laparoscopically assisted total gastrectomy LATG LATG open distal gastrectomy ODG 1 ST NCCN CCU LADG 1 2 TNM x 珋 ± s n BMI n n kg /m 2 BⅠ BⅡ Ⅰ Ⅱ Ⅲ ODG ± ± LADG ± ± t /χ P x 珋 ± s n BMI n kg /m 2 Ⅰ Ⅱ Ⅲ OTG ± ± LATG ± ± t /χ P cm 6 cm BⅠ BⅡ 6 cm D 2 BⅠ LATG LADG BⅡ Roux-en-Y sa 4sb 4d a 9 11p 11d 12a 14v LADG 10 mm 5 cm 4 Veress CO 2 6 cm 12 mmhg 10 mm Trocar Roux-en-Y 12 mm 5 cm 5 mm 5 mm 1 10 mm ODG 15 cm Henle 1 14v 1 3 4d 4sb 5 6 Hem-o-lok 6 7 8a 9 11p 12a 14v BⅠ BⅡ 2 4sb 4d OTG 11p ODG Hem-o-lok a p 11d 12a 14v Roux-en-Y 8a 12a Hem-o-lok 42

3 Henle 2 3 Hem-o-lok P < P < P > LADG LATG SPSS ± x 珋 LADG LATG ± s t χ 2 P < P < x 珋 ± s t /min V /ml n ODG ± ± ± ± ± ± 3. 2 LADG ± ± ± ± ± ± 2. 1 t P < < x 珋 ± s t /min V /ml n OTG ± ± ± ± ± ± 2. 1 LATG ± ± ± ± ± ± 2. 3 t P < < ODG % LADG % 3 OTG % % LATG % 43

4 endoscopic mucosal re- 10 section EMR 15 NCCN Guidelines D 1 D 2 2 endoscopic submucosal dissection ESD 4 LADG LATG D 2 LATG LADG ODG LADG OTG LATG LADG LATG Hem-o-lok 44

5 Jemal A Bray F Center MM et al. Global cancer statistics J. CA Cancer J Clin NCCN Clinical Practice Guidelines in Oncology of gastric cancer V. 1 EB /OL http / /www. nccn. org. 3 Park DJ Lee HJ Kim HH et al. Predictors of operative morbidity and mortality in gastric cancer surgery J. Br J Surg Gotoda T Kondo H Ono H et al. A new endoscopic mucosal resection procedure using an insulation-tipped electrosurgical knife for rectal flat lesions Report of two cases J. Gastrointest Endosc Huscher CG Mingoli A Sgarzini G et al. Laparoscopic versus open subtotal gastrectomy for distal gastric cancer five-year results of a randomized prospective trial J. Ann Surg Kim HH Hyung WJ Cho GS et al. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer-- an interim report a phase III multicenter prospective randomized Trial KLASS Trial J. Ann Surg Uyama I Suda K Satoh S. Laparoscopic surgery for advanced gastric cancer current status and future perspectives J. J Gastric Cancer Zhao Y Yu P Hao Y et al. Comparison of outcomes for laparoscopically assisted and open radical distal gastrectomy with lymphadenectomy for advanced gastric cancer J. Surg Endosc Gordon AC Kojima K Inokuchi M et al. Long-term comparison of laparoscopy-assisted distal gastrectomy and open distal gastrectomy in advanced gastric cancer J. Surg Endosc Roviello F Rossi S Marrelli D et al. Number of lymph node metastases and its prognostic significance in early gastric cancer a multicenter Italian study J. J Surg Oncol Song KY Kim SN Park CH. Laparoscopy-assisted distal gastrectomy with D 2 lymph node dissection for gastric cancer technical and oncologic aspects J. Surg Endosc Ohtani H Tamamori Y Noguchi K et al. A meta analysis of randomized controlled trials that compared laparoscopy-assisted and open distal gastrectomy for early gastric cancer J. J Gastrointest Surg Kim YW Yoon HM Yun YH et al. Long-term outcomes of laparoscopy-assisted distal gastrectomy for early gastric cancer result of a randomized controlled trial COACT 0301 J. Surg Endosc Takiguchi S Fujiwara Y Yamasaki M et al. Laparoscopy-assisted distal gastrectomy versus open distal gastrectomy A prospective randomized single-blind study J. World J Surg Huang YL Lin HG Yang JW et al. Laparoscopy-assisted versus open gastrectomy with D2 lymph node dissection for advanced gastric cancer a meta-analysis J. Int J Clin Exp Med Junfeng S Jun L Jianwei W et al. Meta-analysis of randomized controlled trials on laparoscopic gastrectomy vs open gastrectomy for distal gastric cancer J. Hepato Gastroenterol Ryu KW Kim YW Lee JH et al. Surgical complications and the risk factors of laparoscopy-assisted distal gastrectomy in early gastric cancer J. Ann Surg Oncol