Hand-assisted laparoscopic surgery versus open surgery in D₂ radical gastrectomy

Abstract

Objective To investigate the clinical efficacy and safety of hand-assisted laparoscopic surgery (HALS) in D2 radical gastrectomy. Methods Sixty patients with gastric cancer who underwent radical surgery at Ma'anshan Shiqiye Hospital from April 2017 to December 2020 were selected as the study subjects. They were randomly divided into a HALS group of 30 patients and a traditional open surgery (OS) group of 30 patients by a lottery method. The intra- and post-operative indicators of the two groups were compared, and the survival status was followed up on December 10, 2022. Results In HALS group, the operation time was longer, the intraoperative blood loss and the incision length were smaller, time to exhaust, time to intaking total fluid diet and time to getting out of bed after operation were earlier, and the numerical pain rating (NRS) scores at 6-, 12-, 24- and 48-h after operation were lower, compared with those in OS group (P＜0.05＝. There was no statistical difference in the removal time of abdominal drainage tubes, postoperative hospital stay, number of lymph nodes cleaned, disease-free survival and overall survival between two groups (P＞0.05). The overall incidence of postoperative complications in HALS group was significantly lower than that in OS group (16.67%vs 40.00%, χ=4.02, P＜0.05). Conclusion HALS has lesser trauma and fewer postoperative complications, with safe and feasible in D2 radical surgery for gastric cancer patients. HALS combines the minimally invasive characteristics of laparoscopic surgery with the touch of the surgeon's hand, which reduces the difficulty of operation and is more convenient for complicated abdominal surgery, and can become one of the surgical treatment methods for gastric cancer.

Keywords

• hand-assisted
• laparoscopic surgery
• open surgery
• radical gastrectomy
• d₂ lymphadenectomy