39. Impact of operation time on laparoscopy - assisted distal gastrectomy with D2 lymph node dissection for gastric cancer

Objective: To investigate the operation time and its associated factors for laparoscopy-assisted distal gastrectomy (LADG) with D2 lymph node dissection.
Methods: Clinical data of 332 patients with gastric cancer undergoing LADG with D2 lymph node dissection from Jan. 2007 to Dec. 2010 were analyzed retrospectively. The average operation time was (205±56) minutes. Operative indices and postoperative recovery between patients with operation time ≥205 min (long-time group) and operation time <205 min (short-time group). Risk factors associated with operation time were assessed by univariate and multivariate analyses.
Results: The mean blood loss, time to ground activities, time to first flatus and postoperative hospital stay between the two groups were significant difference (P<0.05), while there were no significant difference in transfused patients and time to resume soft diet. The postoperative complication rate in long-time group was higher than for shorttime group (P<0.05). According to univariate analysis, body mass index (BMI), depth of invasion, lymph node matastasis, surgeon experience and reconstruction were significantly associated with the operation time. Logistic regression analysis revealed that BMI, lymph node matastasis and surgeon experience were independent risk factors for operation time. According to Pearson analysis, operation time positively related with BMI and positive lymph node count, but negatively with surgical cases.
Conclusions: Surgeons who have limited experience in LADG with D2 lymph node dissection may shorten operation time by considering BMI and lymph node matastasis. It is benefit for patients’ recovery.