Abstract:Objective?To investigate the effect of minimally invasive surgery in patients with midge-upper advanced gastric cancer (AGC).?Methods?167 patients with middle-upper AGC underwent total gastrectomy+D2 lymph node dissection from January 2009 to December 2013 were enrolled in the study and divided into laparoscopic assisted total gastrectomy (LATG) group (n = 57) and open total gastrectomy (OTG) group (n = 110). Baseline data, operative, postoperative data and follow-up result were compared between the two groups.?Results?There were no significant differences in baseline data between the two groups (P > 0.05); The intraoperative blood loss and incision length in LATG group were significantly lower than that in OTG group (P < 0.05). There were no significant differences in operation time, ratio of intraoperative blood transfusion, distance between the upper margin and the tumor, the number of lymph node dissection between two groups (P > 0.05); Postoperative first aerofluxus time, ecovery liquid diet time, postoperative hospitalization days and VAS score of pain in 3 d after operation in LATG group were significantly lower than that in OTG group (P < 0.05). There was no significant differences in incidences of postoperative complication between two groups (P > 0.05); There was no patient dying within 30 d after surgery. The median follow-up time was 38.2 months (1~58 months). Postoperative 1, 3 year overall survival rates in LATG group and OTG group were 87.7% and 83.6%, 71.9% and 64.5%, and there were no significant differences between the two groups (P > 0.05).?Conclusion?For patients with middle-upper AGC, LATG+D2 lymph node dissection has lots of advantages including less intraoperative blood loss, shorter incision, faster postoperative recovery, shorter hospital stay and so on, which is safe and effective, and their short-and long-term results are satisfactory.
