Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 28, 2012; 18(8): 833-839
Published online Feb 28, 2012. doi: 10.3748/wjg.v18.i8.833
D2 dissection in laparoscopic and open gastrectomy for gastric cancer
Ming Cui, Jia-Di Xing, Wei Yang, Yi-Yuan Ma, Zhen-Dan Yao, Nan Zhang, Xiang-Qian Su
Ming Cui, Jia-Di Xing, Yi-Yuan Ma, Zhen-Dan Yao, Nan Zhang, Xiang-Qian Su, 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
Wei Yang, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Ultrasound, Peking University Cancer Hospital and Institute, Beijing 100142, China
Author contributions: Su XQ conceived and designed the study; Su XQ, Cui M, Xing JD and Ma YY performed the operations; Yao ZD and Zhang N collected data; Cui M wrote the manuscript; and Yang W revised the manuscript.
Supported by The Capital Medical Development Research Fund, No. 2009-2093
Correspondence to: Xiang-Qian Su, MD, 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. suxiangqian@gmail.com
Telephone: +86-10-88196579 Fax: +86-10-88122437
Received: September 2, 2011
Revised: October 19, 2011
Accepted: January 18, 2012
Published online: February 28, 2012
Abstract

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 laparoscopy-assisted 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 stage.

RESULTS: 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 significant 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 significantly less blood loss, but a longer operation time (P < 0.001). The morbidity of the LAG group was 9.9%, which was not significantly 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.

Keywords: Gastric cancer; Laparoscopy; Gastrectomy; D2 dissection; Lymph node