Clinical efficacies of totally laparoscopic and laparoscopy-assisted radical total gastrectomies in 373 patients: a multicentre retrospective study

• DOI: 10.3760/cma.j.issn.1673-9752.2017.08.013
• Publication Date: 2017-08-20
• Authors: Qingqi Hong; Wei Wang; Jian Zhang; Lin Fan; Jiaming Zhu; Gang Ji; Su Yan
• Keywords: Medical record

Objective To compare the clinical efficacies of totally laparoscopic and laparoscopy-assisted radical total gastrectomies.

Methods The retrospective cohort study was conducted. The clinicopathological data 373 patients with gastric cancer who underwent or gastrectomies from 7 medical centers in China (82 Affiliated Hospital Qinghai University, 80 Traditional Chinese Medicine Guangdong Province, 60 First Xiamen 51 Hangzhou People′s Hospital, 46 Xi′an Jiaotong 30 Second Jilin University 24 Xijing Fourth Military Medical University) between January 2015 December 2016 were collected. Of patients, 183 190 respectively divided into group (undergoing gastrectomy) gastrectomy), including 63 19 36 44 25 35 20 31 10 17 13 12 Fouth University. Routine five-port method applied for gastrectomy D2 lymphadenectomy. Roux-en-Y anastomosis digestive tract reconstruction, reconstruction performed under laparoscopy via upper abdominal median incision group. Observation indicators: (1) operation postoperative situations; (2) follow-up survival situations. Follow-up using outpatient examination telephone interview to detect overall tumor recurrence metastasis up March 2017. Measurement normal distribution represented as ±s. Comparison groups analyzed by t test. skewed M (range). Comparisons count chi-square test Fisher exact probability.

Results (1) Operation situations: all 2 successful operations, without perioperative death. Esophagojejunostomy methods group: conventional circular stapler 28 anti-puncture staplar 6 OrVil™ 5 functional end-to-end esophagojejunostomy 65 peristalsis side-to-side 79 patients. Conventional time, time esophagojejunostomy, length assisted incision, analgesics expenses (238±55)minutes, (29±9)minutes, (5.1±1.1)cm, (2.2±1.0)days, (18 332±2 141)yuan (217±39)minutes, (26±7)minutes, (7.8±2.0)cm, (2.7±0.9)days, (16 237±1 923)yuan group, respectively, statistically significant differences (t=4.324, 3.455, -16.835, -5.561, 9.949, P 0.05). All complications cured symptomatic treatment. 336 followed 4-26 months, a 166 170 During follow-up, cases survival, 150, 10, 16 154, 9, (10 9 simutaneous metastasis), showing no difference (χ2=0.075, 0.010, P>0.05).

Conclusions Total are safe feasible, equivalent outcomes effects esophagojejunostomy. Compared gastrectomy, pain is less, but there longer higher reconstruction.

Key words: Gastric neoplasms; Radical resection; Esophagojejunostomy; Laparoscopy; Multicenter; Retrospective