Laparoscopic-assisted versus open radical gastrectomy for gastric cancer: comparison of clinical effects and influence on intestinal barrier function
Objective: To compare the clinical effects and influences on postoperative intestinal barrier function between laparoscopic-assisted and traditional open radical gastrectomy for gastric cancer. Methods: Forty-one eligible patients with gastric cancer from January 2016 to June 2016 were enrolled. Of the patients, 21 cases underwent laparoscopic-assisted D2 radical gastrectomy (laparoscopic group), and 20 cases underwent open D2 radical surgery (laparotomy group). The main clinical variables and changes in the plasma concentrations of diamine oxidase (DAO) and endotoxin (ETX) before and after operation between the two groups of patients were compared. Results: The general clinical data of the two groups of patients were comparable. Laparoscopic group was superior to laparotomy group in terms of incision length and intraoperative blood loss, but its operative time was longer than that in laparotomy group (all P<0.05), while, no significant difference was noted in other clinical variables that included intraoperative blood infusion requirements, number of lymph node resection, surgical margins and time to postoperative gas passage between the two groups of patients (all P>0.05). The plasma levels of DAO and ETX were significantly increased in both groups on postoperative day one compared with their preoperative levels (all P<0.05), but all returned to their preoperative levels later, and the DAO and ETX levels showed no significant difference between the two group before operation and at any observed time point after operation (all P>0.05). Further, there was a positive correlation betweern DAO and ETX levels in either group of patients (r=0.759; r=0.559, both P<0.05). The incidence of infectious complications showed no significant difference between the two groups (P>0.05). Conclusion: Laparoscopic-assisted radical gastrectomy is as safe and effective as traditional open radical gastrectomy, and it also does not increase the impact on intestinal barrier function.