Comparison of laparoscopy‑assisted surgery and laparotomy for treating locally advanced distal gastric antral cancer

Fang,Fa; Han,Feng; Ding,Yin‑Lu; Wang,Hai‑Jiang

doi:10.3892/etm.2013.1199

Comparison of laparoscopy‑assisted surgery and laparotomy for treating locally advanced distal gastric antral cancer

Authors:
- Fa Fang
- Feng Han
- Yin‑Lu Ding
- Hai‑Jiang Wang
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Affiliations: Department of Gastrointestinal Surgery, The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000, P.R. China, Department of Emergency, The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000, P.R. China, Department of General Surgery, The Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China
Published online on: July 3, 2013 https://doi.org/10.3892/etm.2013.1199
Pages: 753-758

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Abstract

The aim of this study was to investigate the safety, feasibility and mid‑term results of laparoscopy‑assisted surgery in the treatment of locally advanced gastric antral cancer. The clinical data of 50 patients who received laparoscopy‑assisted surgery (Group A) and 62 patients who were treated by conventional laparotomy (Group B) from August 2009 to January 2011 were retrospectively analyzed. The surgical incision length, the volume of blood loss, the intestinal function recovery time, the postoperative complications, the postoperative 1‑ and 3‑year cumulative survival rates and the average survival time in the two groups were observed. The results of the two groups were compared using the χ2 test for the enumeration data, a t‑test for the numerical data and a Wilcoxon rank sum test for the skewed data. In addition, the Kaplan‑Meier method of single factor analysis was utilized to comwpare the 1‑ and 3‑year cumulative survival rates, as well as the average survival time of the two groups. The results indicated that the duration of surgery for Group A was significantly longer compared with that of Group B (P<0.05); however, the incision length and the volume of intraoperative blood loss in Group A were significantly smaller compared with those of Group B (P<0.01). Furthermore, in Group A, the recovery of intestinal function was more rapid and the time spent in hospital was shorter. However, between Groups A and B, the respective number of dissected lymph nodes (16.3 and 17.2), 1‑year survival rates (86.0 and 88.6%) and 3‑year survival rates (52.6 and 53.7%) were not significantly different (P<0.05). The results indicate that laparoscopy‑assisted surgery is a safe approach for the treatment of locally advanced gastric antral cancer and has beneficial treatment effects. Laparoscopy‑assisted surgery is advantageous compared with laparotomy, due to the smaller incision length and reductions in intraoperative blood loss, invasiveness, postoperative recovery time and the number of complications.

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1	Jemal A, Center MM, DeSantis C and Ward EM: Global patterns of cancer incidence and mortality rates and trends. Cancer Epidemiol Biomarkers Prev. 19:1893–1907. 2010. View Article : Google Scholar : PubMed/NCBI
2	Sankaranarayanan R, Swaminathan R, Brenner H, et al: Cancer survival in Africa, Asia, and Central America: a populationbased study. Lancet Onco. 11:165–173. 2010. View Article : Google Scholar : PubMed/NCBI
3	Coleman MP, Quaresma M, Berrino F, et al: Cancer survival in five continents: a worldwide population-based study (CONCORD). Lancet Oncol. 2008.9:730–756
4	Goh PM, Khan AZ, So JB, et al: Early experience with laparoscopic radical gastrectomy for advanced gastric cancer. Surg Laparosc Endosc Percutan Tech. 11:83–87. 2001. View Article : Google Scholar : PubMed/NCBI
5	Bouras G, Lee SW, Nomura E, et al: Comparative analysis of station-specific lymph node yield in laparoscopic and open distal gastrectomy for early gastric cancer. Surg Laparosc Endosc Percutan Tech. 21:424–428. 2011. View Article : Google Scholar : PubMed/NCBI
6	Montesani C, D'Amato A, Santella S, et al: Billroth I versus Billroth II versus Roux-en-Y after subtotal gastrectomy. Prospective [correction of prespective] randomized study. Hepatogastroenterology. 49:1469–1473. 2002.PubMed/NCBI
7	Kitano S, Iso Y, Moriyama M and Sugimachi K: Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 4:146–148. 1994.PubMed/NCBI
8	Kitano S, Shiraishi N, Kakisako K, et al: Laparoscopy-assisted Billroth-I gastrectomy (LADG) for cancer: our 10 years' experience. Surg Laparosc Endosc Percutan Tech. 12:204–207. 2002.PubMed/NCBI
9	Huscher CG, Mingoli A, Sgarzini G, et al: Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg. 241:232–237. 2005.PubMed/NCBI
10	Weber KJ, Reyes CD, Gagner M and Divino CM: Comparison of laparoscopic and open gastrectomy for malignant disease. Surg Endosc. 17:968–971. 2003. View Article : Google Scholar : PubMed/NCBI
11	Lee SI, Choi YS, Park DJ, et al: Comparative study of laparoscopy-assisted distal gastrectomy and open distal gastrectomy. J Am Coll Surg. 202:874–880. 2006. View Article : Google Scholar : PubMed/NCBI
12	Fujiwara M, Kodera Y, Misawa K, et al: Longterm outcomes of early-stage gastric carcinoma patients treated with laparoscopy-assisted surgery. J Am Coll Surg. 206:138–143. 2008. View Article : Google Scholar : PubMed/NCBI
13	Kim MC, Jung GJ and Kim HH: Learning curve of laparoscopy-assisted distal gastrectomy with systemic lymphadenectomy for early gastric cancer. World J Gastroenterol. 11:7508–7511. 2005.PubMed/NCBI
14	Jin SH, Kim DY, Kim H, et al: Multidimensional learning curve in laparoscopy-assisted gastrectomy for early gastric cancer. Surg Endosc. 21:28–33. 2007. View Article : Google Scholar : PubMed/NCBI
15	Tokunaga M, Hiki N, Fukunaga T, et al: Quality control and educational value of laparoscopy-assisted gastrectomy in a high-volume center. Surg Endosc. 23:289–295. 2009.PubMed/NCBI
16	Minutolo V, Gagliano G, Rinzivillo C, et al: Usefullness of the ultrasonically activated scalpel in laparoscopic cholecystectomy: our experience and review of literature. G Chir. 29:242–245. 2008.PubMed/NCBI
17	Tucker RD: Laparoscopic electrosurgical injuries: survey results and their implications. Surg Laparosc Endosc. 5:311–317. 1995.PubMed/NCBI
18	Zeng YK, Yang ZL, Peng JS, et al: Laparoscopy-assisted versus open distal gastrectomy for early gastric cancer: evidence from randomized and nonrandomized clinical trials. Ann Surg. 256:39–52. 2012. View Article : Google Scholar
19	Oz BS, Mataraci I, Iyem H, et al: Comparison of ultrasonically activated scalpel and traditional technique in radial artery harvesting: clinical research. Thorac Cardiovasc Surg. 55:104–107. 2007. View Article : Google Scholar : PubMed/NCBI
20	Satoh S, Okabe H, Kondo K, et al: Video. A novel laparoscopic approach for safe and simplified suprapancreatic lymph node dissection of gastric cancer. Surg Endosc. 23:436–437. 2009. View Article : Google Scholar : PubMed/NCBI
21	Ogura G, Nakamura R, Muragaki Y, et al: Development of an articulating ultrasonically activated device for laparoscopic surgery. Surg Endosc. 23:2138–2142. 2009. View Article : Google Scholar : PubMed/NCBI
22	Martínez-Ramos D, Miralles-Tena JM, Cuesta MA, et al: Laparoscopy versus open surgery for advanced and resectable gastric cancer: a meta-analysis. Rev Esp Enferm Dig. 103:133–141. 2011.PubMed/NCBI
23	Varela JE, Hiyashi M, Nguyen T, et al: Comparison of laparoscopic and open gastrectomy for gastric cancer. Am J Surg. 192:837–842. 2006. View Article : Google Scholar : PubMed/NCBI
24	Usui S, Yoshida T, Ito K, et al: Laparoscopy-assisted total gastrectomy for early gastric cancer: comparison with conventional open total gastrectomy. Surg Laparosc Endosc Percutan Tech. 15:309–314. 2005. View Article : Google Scholar : PubMed/NCBI
25	Kim YW, Han HS and Fleischer GD: Hand-assisted laparoscopic total gastrectomy. Surg Laparosc Endosc Percutan Tech. 13:26–30. 2003. View Article : Google Scholar : PubMed/NCBI
26	Reymond MA, Bien N, Pross M and Lippert H: The status of port-site recurrence. Kongressbd Dtsch Ges Chir Kongr. 118:187–191. 2001.(In German).
27	Stocchi L and Nelson H: Wound recurrences following laparoscopic-assisted colectomy for cancer. Arch Surg. 135:948–958. 2000. View Article : Google Scholar : PubMed/NCBI
28	Person B and Cera SM: Prolonged postlaparoscopy carbon dioxide pneumoperitoneum. Surg Laparosc Endosc Percutan Tech. 18:114–117. 2008. View Article : Google Scholar : PubMed/NCBI
29	Fuganti PE, Rodrigues AJ Júnior, Rodrigues CJ and Sato M: A comparison of the effects of pneumoperitoneum and laparotomy on natural killer cell mediated cytotoxicity and Walker tumor growth in Wistar rats. Surg Endosc. 20:1858–1861. 2006. View Article : Google Scholar : PubMed/NCBI
30	Kosugi C, Ono M, Saito N, et al: Port site recurrence diagnosed by positron emission tomography after laparoscopic surgery for colon cancer. Hepatogastroenterology. 52:1440–1443. 2005.PubMed/NCBI
31	Hirabayashi Y, Yamaguchi K, Shiraishi N, et al: Port-site metastasis after CO₂ pneumoperitoneum: role of adhesion molecules and prevention with antiadhesion molecules. Surg Endosc. 18:1113–1117. 2004. View Article : Google Scholar : PubMed/NCBI
32	Iwanaka T, Arya G and Ziegler MM: Mechanism and prevention of port-site tumor recurrence after laparoscopy in a murine model. J Pediatr Surg. 33:457–461. 1998. View Article : Google Scholar : PubMed/NCBI
33	Reymond MA, Wittekind C, Jung A, et al: The incidence of port-site metastases might be reduced. Surg Endosc. 11:902–906. 1997. View Article : Google Scholar : PubMed/NCBI
34	Ziprin P, Ridgway PF, Peck DH and Darzi AW: The theories and realities of port-site metastases: a critical appraisal. J Am Coll Surg. 195:395–408. 2002.PubMed/NCBI
35	Dulucq JL, Wintringer P, Stabilini C, et al: Laparoscopic and open gastric resections for malignant lesions: a prospective comparative study. Surg Endosc. 19:933–938. 2005. View Article : Google Scholar : PubMed/NCBI
36	Pugliese R, Maggioni D, Sansonna F, et al: Total and subtotal laparoscopic gastrectomy for adenocarcinoma. Surg Endosc. 21:21–27. 2007. View Article : Google Scholar : PubMed/NCBI
37	Shimizu S, Noshiro H, Nagai E, et al: Laparoscopic gastric surgery in a Japanese institution: analysis of the initial 100 procedures. J Am Coll Surg. 197:372–378. 2003. View Article : Google Scholar : PubMed/NCBI
38	Kitano S, Shiraishi N, Uyama I, et al: A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 245:68–72. 2007. View Article : Google Scholar : PubMed/NCBI