Advertisement

Indian Journal of Surgery

, Volume 81, Issue 4, pp 360–365 | Cite as

Clinical Comparative Study of Laparoscopic D2 Radical Gastrectomy and Open Operation for Gastric Cancer

  • Ji-Wu YangEmail author
  • Wei Cheng
  • Peng-Ju Zhao
Original Article
  • 25 Downloads

Abstract

This study aims to evaluate the clinical curative effect of laparoscopic D2 radical gastrectomy for distal gastric cancer, investigate the advantages of this surgical method in clinic, and analyze its related complications. In the First Affiliated Hospital of Dali University, 51 laparoscopic and 51 open-radical operation patients were selected from April 2012 to August 2016. These patients were compared under the following parameters: incision length, intra-operative blood loss, recovery time of postoperative intestinal function, hospitalization duration, and postoperative leukocyte count on the first day. The incision length was 7.3 cm and 17.2 cm for patients in the laparoscopic group and open group, respectively (P < 0.01). Intraoperative blood loss was significantly lesser in the laparoscopic group than in the open group (202.3 ml vs. 405.5 ml, P < 0.01). Gastrointestinal function recovered more quickly in the laparoscopic group than in the open group (exhaust time: 3.5 days vs. 5.0 days, P < 0.01; solid food taking time: 5.0 days vs. 6.0 days, P < 0.01). Hospitalization duration was shorter in the laparoscopic group than in the open group (12 days vs. 16 days, P < 0.01). Postoperative leukocyte count on the first day was lower in the laparoscopic group than in the open group (8.08 × 109 vs. 11.51 × 109, P < 0.01).Laparoscopic D2 radical gastrectomy may be as beneficial as open operation for patients with gastric cancer, as previously suggested.

Keywords

Gastric cancer Radical gastrectomy Laparoscopy Open operation D2 radical operation Clinical curative effect Comparison study 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386.  https://doi.org/10.1002/ijc.29210 CrossRefGoogle Scholar
  2. 2.
    Kitano S, Iso Y, Moriyama M, Sugimachi K (1994) Laparoscopic-assisted Billroth I gastrectomy. Surg Laparoac Endosc 4:146–148Google Scholar
  3. 3.
    Goh PM, Khan AZ, So JB, Lomanto D, Cheah WK, Muthiah R, Gandhi A (2001) Early experience with laparoscopic radical gastrectomy for advanced gastric cancer. Surg Laparosc Endosc Percutan Tech 11:83–87Google Scholar
  4. 4.
    Zang L, Ma JJ, Zheng MH (2017) Reconsideration of hot topics on laparoscopic radical gastrectomy. Chin J Gastrointest Surg 20:841–846. [In Chinese, English abstract].  https://doi.org/10.3760/cma.j.issn.1671-0274.2017.08.001 Google Scholar
  5. 5.
    Uyama I, Suda K, Satoh S (2013) Laparoscopic surgery for advanced gastric cancer: current status and future perspectives. Gastric Cancer 13:19–25.  https://doi.org/10.5230/jgc.2013.13.1.19 CrossRefGoogle Scholar
  6. 6.
    Shuang J, Qi S, Zheng J, Zhao Q, Li J, Kang Z, Hua J, Du J (2011) A case-control study of laparoscopy-assisted and open distal gastrectomy for advanced gastric cancer. J Gastrointest Surg 15:57–62.  https://doi.org/10.1007/s11605-010-1361-1 CrossRefGoogle Scholar
  7. 7.
    Zou ZH, Zhao LY, Mou TY, Hu YF, Yu J, Liu H, Chen H, Wu JM, An SL, Li GX (2014) Laparoscopic vs open D2 gastrectomy for locally advanced gastric cancer: a meta-analysis. World J Gastroenterol 20:16750–16764.  https://doi.org/10.3748/wjg.v20.i44.16750 CrossRefGoogle Scholar
  8. 8.
    Wei HB, Wei B, Qi CL, Chen TF, Huang Y, Zheng ZH, Huang JL, Fang JF (2011) Laparoscopic versus open gastrectomy with D2 lymph node dissection for gastric cancer: a meta-analysis. Surg Laparosc Endosc Percutan Tech 21:383–390.  https://doi.org/10.1097/SLE.0b013e31822d02dc CrossRefGoogle Scholar
  9. 9.
    Straatman J, van der Wielen N, Cuesta MA, de Lange-de Klerk ES, Jansma EP, van der Peet DL (2016) Minimally invasive versus open total gastrectomy for gastric cancer: a systematic review and meta-analysis of short-term outcomes and completeness of resection. World J Surg 40:148–157.  https://doi.org/10.1007/s00268-015-3223-1 CrossRefGoogle Scholar
  10. 10.
    van der Wielen N, Straatman J, Cuesta MA, Daams F, van der Peet DL (2018) Short-term outcomes in minimally invasive versus open gastrectomy: the differences between east and west. A systematic review of the literature. Gastric Cancer 21:19–30.  https://doi.org/10.1007/s10120-017-0747-0 CrossRefGoogle Scholar
  11. 11.
    Xie D, Yu C, Liu L, Osaiweran H, Gao C, Hu J, Gong J (2016) Short-term outcomes of laparoscopic D2 lymphadenectomy with complete mesogastrium excision for advanced gastric cancer. Surg Endosc 30:5138–5139.  https://doi.org/10.1007/s00464-016-4847-4 CrossRefGoogle Scholar
  12. 12.
    Kim CH, Song KY, Park CH, Seo YJ, Park SM, Kim JJ (2015) A comparison of outcomes of three reconstruction methods after laparoscopic distal gastrectomy. J Gastric Cancer 15:46–52.  https://doi.org/10.5230/jgc.2015.15.1.46 CrossRefGoogle Scholar
  13. 13.
    Zong L, Chen P (2011) Billroth I vs. Billroth II vs. Roux-en-Y following distal gastrectomy: a meta-analysis based on 15 studies. Hepatogastroenterology 58:1413–1424.  https://doi.org/10.5754/hge10567 CrossRefGoogle Scholar
  14. 14.
    In Choi C, Baek DH, Lee SH, Hwang SH, Kim DH, Kim KH, Jeon TY, Kim DH (2016) Comparison between Billroth-II with Braun and Roux-en-Y reconstruction after laparoscopic distal gastrectomy. J Gastrointest Surg 20:1083–1090.  https://doi.org/10.1007/s11605-016-3138-7 CrossRefGoogle Scholar
  15. 15.
    Mai C, Tang YQ, Zhao HY, Tang H (2014) Comparison of long-term outcomes between Billroth-I and Roux-en-Y reconstruction after distal gastrectomy. Chin J Gastrointest Surg 17:449–452. [In Chinese, English abstract].  https://doi.org/10.3760/cma.j.issn.1671-0274.2014.05.010 Google Scholar
  16. 16.
    Inokuchi M, Kojima K, Yamada H, Kato K, Hayashi M, Motoyama K, Sugihara K (2013) Long-term outcomes of Roux-en-Y and Billroth-I reconstruction after laparoscopic distal gastrectomy. Gastric Cancer 16:67–73.  https://doi.org/10.1007/s10120-012-0154-5 CrossRefGoogle Scholar
  17. 17.
    Park JY, Kim YJ (2014) Uncut Roux-en-Y reconstruction after laparoscopic distal gastrectomy can be a favorable method in terms of gastritis, bile reflux, and gastric residue. J Gastric Cancer 14:229–237.  https://doi.org/10.5230/jgc.2014.14.4.229 CrossRefGoogle Scholar
  18. 18.
    Ma JJ, Zang L, Yang A, Hu WG, Feng B, Dong F, Wang ML, Lu AG, Li JW, Zheng MH (2017) A modified uncut Roux-en-Y anastomosis in totally laparoscopic distal gastrectomy: preliminary results and initial experience. Surg Endosc 31:4749–4755.  https://doi.org/10.1007/s00464-017-5551-8 CrossRefGoogle Scholar
  19. 19.
    Yang D, He L, Tong WH, Jia ZF, Su TR, Wang Q (2017) Randomized controlled trial of uncut Roux-en-Y vs Billroth II reconstruction after distal gastrectomy for gastric cancer: which technique is better for avoiding biliary reflux and gastritis? World J Gastroenterol 23:6350–6356.  https://doi.org/10.3748/wjg.v23.i34.6350 CrossRefGoogle Scholar

Copyright information

© Association of Surgeons of India 2018

Authors and Affiliations

  1. 1.No.2 Department of General SurgeryFirst Affiliated Hospital of Dali UniversityDaliChina

Personalised recommendations