D2 dissection in laparoscopic and open gastrectomy for gastric cancer

作     者：Ming Cui lia-Di Xing Yi-Yuan Ma Zhen-Dan Yao Nan Zhang Xiang-Qian Su Wei Yang 

作者机构：Key Laboratory of Carcinogenesis and Translational Research （Ministry of Education） Department of Minimally Invasive Gastrointestinal Surgery Peking University Cancer Hospital and Institute Beijing 100142 China Key Laboratory of Carcinogenesis and Translational Research （Ministry of Education） Department of Ultrasound Peking University Cancer Hospital and Institute Beijing 100142 China 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2012年第18卷第8期

页      面：833-839页

核心收录：

学科分类：090603[农学-临床兽医学] 0831[工学-生物医学工程（可授工学、理学、医学学位）] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 08[工学] 09[农学] 0906[农学-兽医学] 10[医学] 

基　　金：Supported by The Capital Medical Development Research Fund  No. 2009-2093 

主　　题：Gastric cancer Laparoscopy Gastrectomy D2 dissection Lymph node 

摘      要：AIM: To evaluate the radicalness and safety of laparoscopic D2 dissection for gastric cancer. METHODS: Clinicopathological data from 209 patients with gastric cancer, who underwent radical gastrectomy with D2 dissection between January 2007 and February 2011, were analyzed retrospectively. Among these patients, 131 patients underwent laparoscopyassisted gastrectomy (LAG) and 78 underwent open gastrectomy (OG). The parameters analyzed included operative time, blood loss, blood transfusion, morbidity, mortality, the number of harvested lymph nodes (HLNs), and pathological ***: There were no significant differences in sex, age, types of radical resection [radical proximal gastrectomy (PG + D2), radical distal gastrectomy (DG + D2) and radical total gastrectomy (TG + D2)], and stages between the LAG and OG groups (P 0.05). Among the two groups, 127 cases (96.9%) and 76 cases (97.4%) had 15 or more HLNs, respectively. The average number of HLNs was 26.1 ± 11.4 in the LAG group and 24.2 ± 9.3 in the OG group (P = 0.233). In the same type of radical resection, there were no signifi cant differences in the number of HLNs between the two groups (PG + D2: 21.7 ± 7.5 vs 22.4 ± 9.3; DG + D2: 25.7 ± 11.0 vs 22.3 ± 7.9; TG + D2: 30.9 ± 13.4 vs 29.3 ± 10.4; P 0.05 for all comparisons). Tumor free margins were obtained in all cases. Compared with OG group, the LAG group had signifi cantly less blood loss, but a longer operation time (P 0.001). The morbidity of the LAG group was 9.9%, which was not signifi cantly different from the OG group (7.7%) (P = 0.587). The mortality was zero in both groups. CONCLUSION: Laparoscopic D2 dissection is equivalent to OG in the number of HLNs, regardless of tumor location. Thus, this procedure can achieve the same radicalness as OG.