Abstract:

Objective

To study the application effect of laparoscopic D2 radical gastrectomy combined with No.16 lymph node dissection in patients with locally advanced gastric cancer.

Methods

A total of 84 patients with locally advanced gastric cancer （LAGC） admitted to the hospital from January 2021 to March 2022 were prospectively selected.They were divided into the observation group （n=42 cases） and the control group （n=42 cases） by the random number table method.The observation group underwent laparoscopic D2 radical gastrectomy combined with No.16 lymph node dissection，and the control group underwent laparoscopic D2 radical gastrectomy.Measurement data such as hospitalization cost and intraoperative blood loss of the two groups of patients were expressed as （±s），and independent samples t test was performed； counting data such as the total incidence of postoperative complications were expressed as percentages，and chi-square test was used； the data of Clavien-Dindo complication grading were expressed as frequencies，and rank sum test was performed.The Kaplan-Meier survival curve was drawn，and the Log-Rank test was used to analyze the differences in disease-free survival rate and overall survival rate between the two groups of patients.

Results

There were no statistically significant differences in hospitalization cost，length of hospital stay，total incidence of postoperative complications，and Clavien-Dindo complication grading between the two groups of patients（P＞0.05）.Compared with the control group，the operation time of the observation group was longer，and the intraoperative blood loss，the total number of dissected lymph nodes and the number of positive dissected lymph nodes were more （P＜0.05）.Two years after surgery，the cumulative disease-free survival rate of the patients in the observation group was higher than that in the control group （92.9% vs. 76.2%，Log-Rank χ²=5.098，P＜0.05）.There was no statistically significant difference in the cumulative overall survival rate between the observation group and the control group （95.2% vs. 88.1%，Log-Rank χ²=1.653，P＞0.05）.

Conclusion

For LAGC patients with limited metastasis of No.16 lymph nodes，laparoscopic D2 radical gastrectomy combined with No.16 lymph node dissection can effectively increase the number of dissected lymph nodes during the operation and improve the disease-free survival rate of patients after surgery，but it will prolong the operation time and increase intraoperative bleeding.

Key words: Stomach Neoplasms, Progressive Stage, Laparoscopes, Paraaortic Lymph Nodes, Lymph Node Excision