Objective:To study the safety and feasibility of totally laparoscopic D2 gastrectomy for advanced gastric cancer.
:Methods :The clinical records of advanced gastric cancer patients who had totally laparoscopic or open D2 gastrectomy over a 6year period were compared and analysed retrospectively.
:Results:Seventyone cases were selected in this study, including 26 totally laparoscopic gastrectomy (laparoscopic group) and 45 open gastrectomy (open group). All the operations were performed successfully. There was no significant difference between these two groups in terms of number of lymph node dissection (P＞0.05). The operation time was longer, volume of bleeding was less, and postoperative time of bowel gas passage and hospital stay were shorter in laparoscopic group compared to those in open group(P＜0.05). In open group, 2 cases experienced postoperative complications, including 1 anastomotic bleeding and 1 anastomotic obstruction. This two patients recovered with conservative treatment. No complication was experienced in laparoscopic group. In laparoscopic group, patients were followed up for 4 to 63 months and 1 case was lost, and the 1, 3 and 5y survival rate was 100％（20/20）, 92.3％（12/13）, and 66.7％（2/3） respectively. In open group, patients were followed up for 3 to 65 months and 2 cases were lost, and 1, 3 and 5year survival rate was 100％（37/37）, 90.5％（19/21）, and 71.4％（5/7）respectively. There were no significant differences between these two groups in terms of 1, 3, 5year survival rates(P＞0.05).
:Conclusions:This study reveals that totally laparoscopic D2 gastrectomy is safe and feasible for advanced gastric cancer, and it presents the superior character of minimal invasion.