Laparoscopy-assisted distal gastrectomy with D2 lymphadenectomy for T2b advanced gastric cancers: three years' experience.

摘要

BACKGROUND: The application of laparoscopy-assisted distal gastrectomy (LADG) with advanced gastric cancer (AGC) is a controversial. The purpose of this study was to assess the possibility of using LADG application to AGC. METHODS: Of 160 patients who underwent LADG with D2 lymphadenectomy between April 2004 and March 2007, 26 patients with stage pT2b were selected and compared to 25 patients of the same stage who underwent open distal gastrectomy (ODG) within same period. The comparison was based on the clinicopathologic characteristics, surgical outcome, and follow-up results. RESULTS: There was no significant difference between LADG and ODG groups in most operation results including complication rates (15.4% vs. 16.0%, P = 1.000) except for less average loss of blood (160.0 ml vs. 215.0 ml, P = 0.012) and longer average operating time (255.0 min vs. 190.0 min, P < 0.001) in LADG. Three-year overall survival rates (88.2% vs. 77.2%; P = 0.246) and disease-free survival rates (71.4% vs. 53.4%; P = 0.757) were not significantly different in LADG and ODG groups. CONCLUSIONS: The early results of current study suggest that LADG for AGC is technically safe and oncologically feasible. Therefore, LADG should be considered as a curative treatment for AGC not exposed to serosa.