Abstract: Objective:To explore the clinical effect of threedimensional (3D) laparoscopic radical gastrectomy of gastric cancer.
Methods:The retrospective crosssectional study was conducted. The clinical data of 65 patients with gastric cancer who underwent 3D laparoscopic radical gastrectomy of gastric cancer in the People′s Hospital of Zhengzhou University from January 2015 to July 2016 were collected. There were the same surgical procedure and postoperative treatment between 3D and twodimensional (2D) laparoscopic radical gastrectomy of gastric cancer. Observation indicators: (1) surgical situations: operation time, volume of intraoperative blood loss, number of lymph node dissected; (2) postoperative recovery situations: time to anal exsufflation, time for semiliquid diet intake, duration of hospital stay, treatment expenses and postoperative complications; (3) postoperative pathological situations: pathological classification of gastric cancer, T stage, lymph node metastasis, TNM stage, surgical margin; (4) followup situations. The followup using outpatient examination and telephone interview was performed to detect patients′ survival and tumor metastasis and recurrence up to July 2016. Measurement data with normal distribution were represented as ±s. Measurement data with skewed distribution were described as M (range).
Results:(1) Surgical situations: all the 65 patients underwent successful 3D laparoscopic radical gastrectomy of gastric cancer and D2 lymph node dissection, without the occurrence of conversion to open surgery, intraoperative complications and perioperative death. Operation time, volume of intraoperative blood loss and number of lymph node dissected were (200±55)minutes, (110±80)mL and 32±7, respectively. (2) Postoperative recovery situations: time to anal exsufflation, time for semiliquid diet intake, duration of hospital stay and treatment expenses were (3.1±1.0)days, (5.3±1.6)days, (9.4±3.0)days and (8.1±1.3)×104 yuan, respectively. Of 65 patients, 5 had postoperative complications. One patient with anastomotic leakage underwent percutaneous endoscopic gastrostomy and abdominal drainage again and then was cured. One patient with peritoneal effusion and infection was cured after catheter drainage under CT guided. One patient with delayed gastric emptying was cured after symptomatic treatment. One patient with chylous fistula was cured after shortterm fast and total parenteral nutrition treatment. One patient with pulmonary infection was cured after antibiotic therapy. (3) Postoperative pathological situations: ① Pathological classification of gastric cancer: high and moderatedifferentiated adenocarcinoma was detected in 30 patients, poordifferentiated adenocarcinoma in 20 patients, signet ring cell carcinoma in 11 patients, mucinous adenocarcinoma in 3 patients and papillary adenocarcinoma in 1 patient. ② T stage: 27, 15 and 23 patients were in T1, T2 and T3 stages. ③ Twentyfive patients had lymph node metastases and 40 had no lymph node metastasis. ④ TNM stage: 19, 17, 15, 12 and 2 patients were in ⅠA, ⅠB, Ⅱ, ⅢA and ⅢB, respectively. R₀ resection was performed to all the 65 patients, with negative surgical margin under the microscope. (4) Followup situations: of 65 patients, 61 were followed up for 3-18 months, with a median time of 9 months. During the followup, there was no occurrence of surgeryrelated complications, tumor metastasis and recurrence and death.
Conclusion:The 3D laparoscopic radical gastrectomy of gastric cancer is safe and feasible, with a good shortterm outcome.