The clinical value of laparoscopic assisted radical gastrectomy in the treatment of locally advanced gastric cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 JIANG Yongqiang , CAO Hui , JIANG Bao , ZHEN Tao

Department of General Surgery, HuaiNan Eastern Hospital, Huai Nan, An Hui 232001, P. R. China;

Corresponding author：

JIANG Yongqiang, Email: hndfyypwkjyq@163.com

Keywords：

laparoscopic surgery; open surgery; advanced gastric cancer; radical gastrectomy for gastric cancer

DOI：

10.7507/1007-9424.201903091

Video：

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Objective To assess the outcomes of laparoscopy-assisted surgery for treatment of advanced gastric cancer.Methods A total of 115 patients with advanced gastric cancer were included between January 2014 and December 2018 were analyzed retroprospectively, the patients were divided into two groups: open surgery group (OS group, n=63) and laparoscopy-assisted surgery group (LAS group, n=52). Baseline characteristics, intraoperative parameters and postoperative items, and long-term efficacy were compared between the two groups.Results There was no significant difference in preoperative baseline data including gender, age and preoperative serum parameters between the two groups (P>0.05). Intraoperative blood loss in the LAS group was significantly less than that in the OS group (P<0.05). In addition, the first feeding time after operation and postoperative hospital stay in the LAS group were significantly shorter than the OS group (P<0.05). Furthermore, numbers of white blood cells and neutrophils in the LAS group were fewer than that in the OS group at postoperative 2 days (P<0.05); the level of serum albumin in the LAS group was higher than that OS group (P<0.05). The number of lymph nodes detected during operation in the LAS group was more than that in the OS group (P<0.05). Operative time and occurrence of postoperative complications were not statistically significant between the two groups (P>0.05). One hundred and ten of 115 patients were followed- up, the follow-up rate was 95.7%. The follow-up time ranged from 6 to 48 months, with a median follow-up time of 12.4 months. The disease-free survival time of the OS group was 12.2±6.5 months, while that of the LAS group was 13.5±7.4 months. There was no significant difference between the two groups (P>0.05).Conclusions Laparoscopic technique in treatment of advanced gastric cancer has the minimally invasive advantage, less intraoperative blood loss, less surgical trauma, and faster postoperative recovery in comparing to the traditional open surgery. Also the lymph node dissection is superior to open surgery. The curative effect is comparable to that of open surgery.

Citation： JIANG Yongqiang, CAO Hui, JIANG Bao, ZHEN Tao. The clinical value of laparoscopic assisted radical gastrectomy in the treatment of locally advanced gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(9): 1087-1092. doi: 10.7507/1007-9424.201903091 Copy

1.	李道娟, 梁迪, 靳晶, 等. 上消化道恶性肿瘤流行病学趋势. 肿瘤预防与治疗, 2018, 31(1): 62-68.
2.	左婷婷, 郑荣寿, 曾红梅, 等. 中国胃癌流行病学现状. 中国临床肿瘤, 2017, 44(1): 52-58.
3.	刘文韬, 刘福坤. 2002年版日本胃癌治疗规范. 中华胃肠外科杂志, 2003, 6(2): 131-132.
4.	Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth Ⅰ gastrectomy. Surg Laparosc Endosc, 1994, 4(2): 146-148.
5.	Yamashita K, Sakuramoto S, Kikuchi S, et al. Laparoscopic versus open distal gastrectomy for early gastric cancer in Japan: long-term clinical outcomes of a randomized clinical trial. Surg Today, 2016, 46(6): 741-749.
6.	Amin MB, Greene FL, Edge SB, et al. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more " personalized” approach to cancer staging. CA Cancer J Clin, 2017, 67(2): 93-99.
7.	Hildebrandt T, Emir S, Boosz A, et al. Total laparoscopic hysterectomy: how does training for surgeons in a standardized operation affect hospitals and patients? Arch Gynecol Obstet, 2018, 298(4): 763-771.
8.	De'Angelis N, Abdalla S, Bianchi G, et al. Robotic versus laparoscopic colorectal cancer surgery in elderly patients: a propensity score match analysis. J Laparoendosc Adv Surg Tech A, 2018, 28(11): 1334-1345.
9.	Kasai M, Cipriani F, Gayet B, et al. Laparoscopic versus open major hepatectomy: a systematic review and meta-analysis of individual patient data. Surgery, 2018, 163(5): 985-995.
10.	Date S, Noguchi H, Kaku K, et al. Laparoscopy-assisted spleen-preserving distal pancreatectomy for living-donor pancreas transplantation. Transplant Proc, 2017, 49(5): 1133-1137.
11.	Zheng L, Deng C, Li J, et al. Treatment of hemangioma of the spleen by preoperative partial splenic embolization plus laparoscopic partial splenectomy: A case report. Medicine (Baltimore), 2018, 97(17): e0498.
12.	Wang Z, Xing J, Cai J, et al. Short-term surgical outcomes of laparoscopy-assisted versus open D2 distal gastrectomy for locally advanced gastric cancer in North China: a multicenter randomized controlled trial. Surg Endosc, 2019, 33(1): 33-45.
13.	Li Z, Liu Y, Bai B, et al. Surgical and long-term survival outcomes after laparoscopic and open total gastrectomy for locally advanced gastric cancer: a propensity score-matched analysis. World J Surg, 2019, 43(2): 594-603.
14.	Li Z, Li B, Bai B, et al. Long-term outcomes of laparoscopic versus open D2 gastrectomy for advanced gastric cancer. Surg Oncol, 2018, 27(3): 441-448.
15.	Hao Y, Yu P, Qian F, et al. Comparison of laparoscopy-assisted and open radical gastrectomy for advanced gastric cancer: A retrospective study in a single minimally invasive surgery center. Medicine (Baltimore), 2016, 95(25): e3936.
16.	Li Z, Ji G, Bai B, et al. Laparoscopy-assisted distal gastrectomy versus laparoscopy-assisted total gastrectomy with D2 lymph node dissection for middle-third advanced gastric cancer. Surg Endosc, 2018, 32(5): 2255-2262.
17.	Inokuchi M, Nakagawa M, Tanioka T, et al. Long- and short-term outcomes of laparoscopic gastrectomy versus open gastrectomy in patients with clinically and pathological locally advanced gastric cancer: a propensity-score matching analysis. Surg Endosc, 2018, 32(2): 735-742.
18.	Sura K, Ye H, Vu CC, et al. How many lymph nodes are enough?-defining the extent of lymph node dissection in stage Ⅰ -Ⅲ gastric cancer using the National Cancer Database. J Gastrointest Oncol, 2018, 9(6): 1168-1175.
19.	李旸, 黄理宾, 王自强. 早期胃癌临床病理因素与淋巴结转移规律. 中国普外基础与临床杂志, 2018, 25(7): 812-816.
20.	Park YK, Yoon HM, Kim YW, et al. Laparoscopy-assisted versus open D2 distal gastrectomy for advanced gastric cancer: results from a randomized phase II multicenter clinical trial (COACT 1001). Ann Surg, 2018, 267(4): 638-645.
21.	刘进生, 黄良祥, 曾长青, 等. 141 例腹腔镜远端胃癌 D2 根治术 No.6 组淋巴结清扫的经验总结. 中国普外基础与临床杂志, 2014, 21(4): 437-441.
22.	陆宏伟, 张亚飞, 吉鸿, 等. 腹腔镜胃癌 D2 根治术治疗进展期胃癌的疗效与安全性. 中国普外基础与临床杂志, 2015, 22(3): 317-321.
23.	彭朝阳, 丁恒一, 司建伟. 腹腔镜和开腹原发灶切除联合 D2 淋巴结清扫术治疗老年进展期胃癌临床对比研究. 中国普外基础与临床杂志, 2017, 24(7): 848-853.

1. 李道娟, 梁迪, 靳晶, 等. 上消化道恶性肿瘤流行病学趋势. 肿瘤预防与治疗, 2018, 31(1): 62-68.
2. 左婷婷, 郑荣寿, 曾红梅, 等. 中国胃癌流行病学现状. 中国临床肿瘤, 2017, 44(1): 52-58.
3. 刘文韬, 刘福坤. 2002年版日本胃癌治疗规范. 中华胃肠外科杂志, 2003, 6(2): 131-132.
4. Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth Ⅰ gastrectomy. Surg Laparosc Endosc, 1994, 4(2): 146-148.
5. Yamashita K, Sakuramoto S, Kikuchi S, et al. Laparoscopic versus open distal gastrectomy for early gastric cancer in Japan: long-term clinical outcomes of a randomized clinical trial. Surg Today, 2016, 46(6): 741-749.
6. Amin MB, Greene FL, Edge SB, et al. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more " personalized” approach to cancer staging. CA Cancer J Clin, 2017, 67(2): 93-99.
7. Hildebrandt T, Emir S, Boosz A, et al. Total laparoscopic hysterectomy: how does training for surgeons in a standardized operation affect hospitals and patients? Arch Gynecol Obstet, 2018, 298(4): 763-771.
8. De'Angelis N, Abdalla S, Bianchi G, et al. Robotic versus laparoscopic colorectal cancer surgery in elderly patients: a propensity score match analysis. J Laparoendosc Adv Surg Tech A, 2018, 28(11): 1334-1345.
9. Kasai M, Cipriani F, Gayet B, et al. Laparoscopic versus open major hepatectomy: a systematic review and meta-analysis of individual patient data. Surgery, 2018, 163(5): 985-995.
10. Date S, Noguchi H, Kaku K, et al. Laparoscopy-assisted spleen-preserving distal pancreatectomy for living-donor pancreas transplantation. Transplant Proc, 2017, 49(5): 1133-1137.
11. Zheng L, Deng C, Li J, et al. Treatment of hemangioma of the spleen by preoperative partial splenic embolization plus laparoscopic partial splenectomy: A case report. Medicine (Baltimore), 2018, 97(17): e0498.
12. Wang Z, Xing J, Cai J, et al. Short-term surgical outcomes of laparoscopy-assisted versus open D2 distal gastrectomy for locally advanced gastric cancer in North China: a multicenter randomized controlled trial. Surg Endosc, 2019, 33(1): 33-45.
13. Li Z, Liu Y, Bai B, et al. Surgical and long-term survival outcomes after laparoscopic and open total gastrectomy for locally advanced gastric cancer: a propensity score-matched analysis. World J Surg, 2019, 43(2): 594-603.
14. Li Z, Li B, Bai B, et al. Long-term outcomes of laparoscopic versus open D2 gastrectomy for advanced gastric cancer. Surg Oncol, 2018, 27(3): 441-448.
15. Hao Y, Yu P, Qian F, et al. Comparison of laparoscopy-assisted and open radical gastrectomy for advanced gastric cancer: A retrospective study in a single minimally invasive surgery center. Medicine (Baltimore), 2016, 95(25): e3936.
16. Li Z, Ji G, Bai B, et al. Laparoscopy-assisted distal gastrectomy versus laparoscopy-assisted total gastrectomy with D2 lymph node dissection for middle-third advanced gastric cancer. Surg Endosc, 2018, 32(5): 2255-2262.
17. Inokuchi M, Nakagawa M, Tanioka T, et al. Long- and short-term outcomes of laparoscopic gastrectomy versus open gastrectomy in patients with clinically and pathological locally advanced gastric cancer: a propensity-score matching analysis. Surg Endosc, 2018, 32(2): 735-742.
18. Sura K, Ye H, Vu CC, et al. How many lymph nodes are enough?-defining the extent of lymph node dissection in stage Ⅰ -Ⅲ gastric cancer using the National Cancer Database. J Gastrointest Oncol, 2018, 9(6): 1168-1175.
19. 李旸, 黄理宾, 王自强. 早期胃癌临床病理因素与淋巴结转移规律. 中国普外基础与临床杂志, 2018, 25(7): 812-816.
20. Park YK, Yoon HM, Kim YW, et al. Laparoscopy-assisted versus open D2 distal gastrectomy for advanced gastric cancer: results from a randomized phase II multicenter clinical trial (COACT 1001). Ann Surg, 2018, 267(4): 638-645.
21. 刘进生, 黄良祥, 曾长青, 等. 141 例腹腔镜远端胃癌 D2 根治术 No.6 组淋巴结清扫的经验总结. 中国普外基础与临床杂志, 2014, 21(4): 437-441.
22. 陆宏伟, 张亚飞, 吉鸿, 等. 腹腔镜胃癌 D2 根治术治疗进展期胃癌的疗效与安全性. 中国普外基础与临床杂志, 2015, 22(3): 317-321.
23. 彭朝阳, 丁恒一, 司建伟. 腹腔镜和开腹原发灶切除联合 D2 淋巴结清扫术治疗老年进展期胃癌临床对比研究. 中国普外基础与临床杂志, 2017, 24(7): 848-853.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The clinical value of laparoscopic assisted radical gastrectomy in the treatment of locally advanced gastric cancer

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