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

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.