Objective To compare the treatment effect of laparoscopic D2 gastrectomy (LAG-D2) and open D2 gastrec tomy(OG) in the treatment of patients with advanced gastric cancer,and evaluate the safety of LAG-D2. Methods A total of 67 pa-tients with advanced gastric cancer staging T2,T3,or T4 clinically,were selected from October 2008 and February 2009,including 37 cases in LAG-D2 group and 30 cases in OG group. Both groups were treated with gastric carncer OG ,and resected the lymph nodes in the second station thoroughly. To compare and analyze the general information ,intraoperative condition,postoperative re-sults and pathological features of the patients in the both groups ,and the long-term efficacy was followed up seriously. Results Compared with the OG group,the amount of bleeding was less,postoperative length of stay was shorter but the length of operation was longer in the LAG-D2 group,and the differences between the two groups had statistical significance (P<0.01). The difference be-tween the two groups in incidences of pulmonary infection and incision infection was statistically significant (P<0.01). No death occurred in the both groups in perioperative period. The recurrence rate between the LAG-D2 group [29.7%(11/37)] and the OG group[30.0%(9/30)] had no statistically significant difference(P>0.05). The five-year disease free survival rate and overall survival rate were 64.7%(22/34) and 67.6%(23/34) respectively in the LAG-D2 group,compared with the OG group [64.3%(18/28), 67.9%(19/28)],the differences had no statistical significance (P>0.05). Conclusion In the LAG-D2 and OG groups,it has the similar curative effect in the treatment of advanced gastric cancer and advantages of small incision ,less amount of bleeding,rapid recovery,fewer complications,safe and reliable. So LAG-D2 can replace the traditional OG for advanced gastric cancer.%目的：比较腹腔镜下胃癌D2根治术（LAG-D2）与传统开腹胃癌D2根治术（OG）治疗进展期胃癌患者的临床效果，并评估腹腔镜下手术安全性。方法选择2008年10月至2009年2月术前临床分期为T2、T3或T4的进展期胃癌患者67例，其中LAG-D2组37例，OG组30例。两组患者均严格按照胃癌D2根治术进行，完全清扫第2组淋巴结。观察比较两组患者一般资料、术中情况、术后结果、病理特征，并严格随访两组患者术后的长期疗效。结果 LAG-D2组患者较OG组术中出血更少，术后住院时间明显缩短，但手术时间更长，差异均有统计学意义（P<0.01）。两组患者肺部及切口感染手术并发症发生率比较，差异有统计学意义（P＜0.01）。两组围术期均无死亡病例。LAG-D2组患者复发率[29.7％（11/37）]与OG组[30.0％（9/30）]比较，差异无统计学意义（P>0.05）。LAG-D2组患者5年无瘤生存率和总生存率分别为64.7%（22/34）和67.6％（23/34），OG 组为64.3％（18/28）和67.9％（19/28），两组比较，差异均无统计学意义（P>0.05）。结论LAG-D2与OG对于进展期胃癌治疗其根治性效果相似，具有手术切口小、出血少、恢复快、并发症少、安全可靠等优点。LAG-D2可以替代传统OG治疗进展期胃癌。
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