AB74. Comparative study of open gastrectormy vs. laparoscopy-assisted gastrectomy for gastric cancer
Zhaoqing Tang, Fenglin Liu, Xuefei Wang, Hongshan Wang, Zhenbin Shen, Weidong Chen, Yong Fang, Cong Wang, Yihong Sun, Xinyu Qin
Background: There has been a lot of research comparing the safety and effectiveness of traditional open surgery with those of laparoscopy-assisted gastrectomy, but no consensus has been reached on many indices. Chinese clinicians have been developing laparoscopic gastrectomy lately, and the government has intended to promote and develop such a minimally invasive surgery. Traditional open surgery was compared with laparoscopy-assisted gastrectomy for gastric cancer in terms of safety and effectiveness to provide evidence for scientific decision-making.
Methods: A retrospective cohort design was adopted; surgical cases carried out from 2009-2012 were selected and matched at research site based on the inclusion and exclusion criteria. The exposure group consisted of patients who received laparoscopy-assisted gastrectomy, and the control group consisted of patients who received open gastrectomy. The basic characteristics of the patients, surgery-related events, and postoperative recovery information were collected; surgical results of two groups were compared and analyzed.
Results: Finally, 227 cases were included (laparoscopic group 112, open group 115), there was no significant difference in the distribution of age, gender, health insurance, and preoperative medical history between the two groups. Mean operative duration of the exposure group was significantly higher than that of the control group (239.1±80.2 vs. 161.5±47.2 min, P<0.01). The number of lymph nodes dissected of the exposed group was significantly lower than that of the control group (28.9±9.8 vs. 35.0±11.4, P<0.01). The postoperative feeding time of the exposure group was higher than that of the control group (6.5±4.2 vs. 5.7±3.4 days, P<0.05). There were no significant differences between the two groups in blood loss, postoperative complications, rate of metastasis and relapse and costs of hospital stays (P>0.05). After laparoscopic technic stable, differences between above mentioned aspects became less significant. The surgical learning curve, lymph node dissection type may be the indicators that influence the surgical results.
Conclusions: Laparoscopic gastrectomy is safe, and its therapeutic effect is not inferior to that of open surgery, but no obvious advantage of the effectiveness and costs is found.
Keywords: Gastric cancer; open surgery; laparoscopy-assisted gastrectomy
