Abstract: Objective:To investigate the clinical effect of the outside bursa omentalis approach in the total laparoscopic radical resection of gastric cancer.
Methods:The retrospective crosssectional study was adopted. The clinical data of 52 patients with advanced gastric cancer (AGC) who were admitted to the Guangdong Provincial Hospital of Traditional Chinese Medicine between January 2013 and January 2015 were collected. All the patients underwent total laparoscopic radical resection of gastric cancer using outside bursa omentalis approach. Observation indicators included: (1) surgical situations: surgical procedure, operation time, time of bursa omentalis resection, volume of intraoperative blood loss, (2) postoperative situations: recovery time of gastrointestinal function, complications, duration of hospital stay, (3) postoperative pathological examination: number of lymph node dissected, (4) followup. Followup using outpatient examination and telephone interview was performed to detect the survival of patients and tumor recurrence and metastasis up to December 2015. Measurement data with normal distribution were represented as ±s.
Results:(1) Surgical situations: all the 52 patients underwent successful total laparoscopic radical resection of gastric cancer using outside bursa omentalis approach, without conversion to open surgery and perioperative death. Twentyone patients underwent total gastrectomy and RouxenY esophagojejunostomy. Of 31 patients undergoing distal subtotal gastrectomy, 4 received Billroth Ⅰ anastomosis with digestive tract reconstruction and 27 received Billroth Ⅱ anastomosis. The operation time, time of bursa omentalis resection and volume of intraoperative blood loss in 52 patients were (236± 31)minutes, (38±13)minutes and (59±13)mL, respectively. (2) Postoperative situations: recovery time 〖HJ*3〗of gastrointestinal function of 52 patients was (3.6±0.6)days. Four patients with postoperative complications were improved by conservative treatment, including 2 with inflammatory ileus, 1 with intraabdominal hemorrhage and 1 with pulmonary infection, they were improved by symptomatic or conservative treatment. The duration of hospital stay was (9.4±2.3)days. (3) Postoperative pathological examination: number of lymph node dissected of 52 patients was 26±5. (4) Followup: 52 patients were followed up for 11-26 months with a median time of 16 months. During the followup, there was no death.
Conclusion:Total laparoscopic radical resection of gastric cancer using outside bursa omentalis approach is safe and feasible, with good shortterm outcomes.