THE ROLE OF LAPARASCOPIC GASTRECTOMY AND D2 LYMPHADENECTOMY OF STAGE III GASTRIC CANCER

Thanh Quan Nguyen 1,, Van Lam Nguyen 1
1 Can Tho University of Medecine and Pharmacy

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Abstract

           Background: Gastric cancer is common cancer in the world as well as in Vietnam. Currently, laparoscopic gastrectomy with D2 lymphadenectomy for gastric cancer is a popular treatment. However, there haven’t had many studies on laparoscopic gastrectomy with D2 lymphadenectomy for gastric cancer for stage III in Vietnam. Objectives: Determine the number of retrieved lymph nodes, the rate of conversion to open surgery, operative time, operative blood loss, the number of lymph nodes metastazised after surgery, intraoperative complications, postoperative complications and postoperative survival rate. Materials and methods: A case series study was carried out from January 2017 to June 2021. The research variables included: evaluation of the number of retrieved lymph nodes, the rate of conversion to open surgery, operative time, operative blood loss, the number of metastases after surgery, intraoperative complications, and postoperative complications, postoperative survival rate. Results: There were no cases that had to change to open surgery. The average operative time was 303 ± 7.057 minutes, the average operative blood loss was 65.6 ± 4.705 ml. The average number of retrieved lymph nodes was 13.22 ± 0.631 nodes. There were 34 cases (68%) of lymph node metastasis after surgery. The number of retrieved lymph nodes for lesions at T4a and T4b stages was significantly more than that of lesions below T4a, survival time after 1 year was 93.87% and after 3 years was 76.08%. There was a case of intraoperative bleeding due to laceration of the left gastric artery during surgery which was well managed through laparoscopic surgery, one case died on the 19th day after surgery due to severe pneumonia, respiratory failure and 4 cases. Postoperative pneumonia was treated medically. Conclusion: Laparoscopic gastrectomy with D2 lymphadenectomy is safe in the treatment of stage III gastric cancer. 

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References

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