Details

Autor(en) / Beteiligte

• Hu, Yanfeng
• Huang, Changming
• Sun, Yihong
• Su, Xiangqian
• Cao, Hui
• Hu, Jiankun
• Xue, Yingwei
• Suo, Jian
• Tao, Kaixiong
• He, Xianli
• Wei, Hongbo
• Ying, Mingang
• Hu, Weiguo
• Du, Xiaohui
• Chen, Pingyan
• Liu, Hao
• Zheng, Chaohui
• Liu, Fenglin
• Yu, Jiang
• Li, Ziyu
• Zhao, Gang
• Chen, Xinzu
• Wang, Kuan
• Li, Ping
• Xing, Jiadi
• Li, Guoxin

Titel

Morbidity and Mortality of Laparoscopic Versus Open D2 Distal Gastrectomy for Advanced Gastric Cancer: A Randomized Controlled Trial

Ist Teil von

• Journal of clinical oncology, 2016-04, Vol.34 (12), p.1350-1357

Ort / Verlag

United States

Erscheinungsjahr

2016

Quelle

MEDLINE

Beschreibungen/Notizen

• The safety and efficacy of radical laparoscopic distal gastrectomy (LG) with D2 lymphadenectomy for the treatment of advanced gastric cancer (AGC) remain controversial. We conducted a randomized controlled trial to compare laparoscopic and conventional open distal gastrectomy with D2 lymph node dissections for AGC. Between September 2012 and December 2014, 1,056 patients with clinical stage T2-4aN0-3M0 gastric cancer were eligible for inclusion. They were randomly assigned to either the LG with D2 lymphadenectomy group (n = 528) or the open gastrectomy (OG) with D2 lymphadenectomy group (n = 528). Fifteen experienced surgeons from 14 institutions in China participated in the study. The morbidity and mortality within 30 days after surgery between the LG (n = 519) and the OG (n = 520) groups were compared on the basis of the modified intention-to-treat principle. Postoperative complications were stratified according to the Clavien-Dindo classification. The compliance rates of D2 lymphadenectomy were similar between the LG and OG groups (99.4% v 99.6%; P = .845). The postoperative morbidity was 15.2% in the LG group and 12.9% in OG group with no significant difference (difference, 2.3%; 95% CI, -1.9 to 6.6; P = .285). The mortality rate was 0.4% for the LG group and zero for the OG group (difference, 0.4%; 95% CI, -0.4 to 1.4; P = .249). The distribution of severity was similar between the two groups (P = .314). Experienced surgeons can safely perform LG with D2 lymphadenectomy for AGC.