AB67. Comparation of laparoscopy-assisted and open gastrectomy with laparoscopic equipment in early distal gastric cancer

Introduction: Laparoscopy-assisted gastrectomy (LAG) for early gastric cancer (EGC) was considered as a treatment with many advantages due to the application of laparoscopic equipment. The aim of this study was to compare the blood loss, number of harvested lymph nodes (HLNs), and complications of applicaition of laparoscopic equipment in LAG and open gastrectomy (OG) for EGC.

Methods: Patients received surgical treatment for early distal gastric cancer (EDGC) were retrospectively reviewed. Patients were classified into three groups by different operation methods: traditional open distal gastrectomy (ODG) group, laparoscopy- assisted distal gastrectomy (LADG) group, and open distal gastrectomy with assistance of laparoscopic equipment (ODGA) group.

Results: Altogether 65 patients with EDGC received surgical treatment, including 20 cases of ODG, 22 of LADG, and 23 of ODGA. No lymph node metastasis was found in all patients. Compared with ODG group, the blood loss was significantly reduced in LADG and ODGA groups (106.4±46.0, and 73.3±35.7 mL vs. 250.5±65.1 mL respectively; P<0.01), but the operation time was significantly longer in these two groups (231.0±34.5, and 222.5±42.6 min vs. 128.5±22.3 min respectively; P<0.01). No difference was found in the blood loss, operation time, the number of harvested lymph nodes and the types of gastrointestinal continuity reconstruction between LADG and ODGA group. There is no difference in the postoperative complications among the three groups.

Conclusions: Laparoscopic equipment might be the key factor in the reduction of blood loss and the delay of operation time for LADG. Application of laparoscopic equipment in open gastrectomy can be used as a training method to shorten learning curve for LAG beginners.

Keywords: Early gastric cancer (EGC); laparoscopy; gastrectomy; laparoscopy-assisted gastrectomy (LAG)