腹腔镜辅助远端胃癌根治术的临床应用

目的探讨腹腔镜远端胃癌根治术的可行性及手术方法。方法行腹腔镜远端胃癌根治术15例,D1清扫3例,D2/D2 12例。全部病例均行毕Ⅱ式胃空肠吻合。结果15例成功进行腹腔镜手术。手术时间平均(218.6±31.6)min,术中出血量平均(132.4±21.3)ml,清扫淋巴结平均(33.4±13.6)个。肿瘤近端切缘(6.6±0.9)cm,远端切缘(5.4±0.6)cm,术后肛门排气时间平均(3.5±0.6)d,无手术死亡,无吻合口漏,术后并发肺部感染1例,经治疗后痊愈。术后随访1~10个月,无肿瘤复发或转移。结论腹腔镜远端胃癌根治术能达到与开腹胃癌标准根治术(D2)的淋巴结清扫范围及肿瘤切缘,且具有创伤小、出血少、术后恢复快等优点。     

腹腔镜与开腹胃癌 D2根治术的对比研究

目的：探讨腹腔镜胃癌D2根治术的可行性及有效性。方法2011年1月～2012年1月行腹腔镜胃癌根治术35例（腹腔镜组）,并与同期37例开腹手术（开腹组）比较手术时间、术后恢复、手术并发症等。结果与开腹组比较,腹腔镜组手术时间显著延长[（230．4±40．6） min vs．（160．1±33．5） min,t ＝8．032,P ＝0．000],但术中出血量明显减少[（103．1±77．6）ml vs．（159．4±79．6）ml,t＝-3．036,P＝0．003],肛门排气时间明显缩短[（4．3±0．8）d vs．（5．4±0．9）d, t＝5．336,P＝0．000]。2组近切缘距肿瘤距离[（5．3±0.8）cm vs．（5．0±0．7）cm,t＝1．696,P＝0．094],远切缘距肿瘤距离[（5．3±0．7）cm vs．（5．2±0．7）cm,t＝0．606,P＝0．547],淋巴结清扫数目[（21．1±5．1）枚 vs．（23．1±6．3）枚,t＝-1．476, P＝0．145],第一站淋巴结转移阳性率[42．9％（15/35） vs．45．9％（17/37）,χ2＝0．069,P＝0．792],第二站淋巴结转移阳性率[34．3％（12/35） vs．37．8％（14/37）,χ2＝0．098,P＝0．754]和近期并发症发生率[8．6％（3/35） vs．18．9％（7/37）,χ2＝0.861,P＝0．353]无统计学差异。结论腹腔镜下胃癌D2根治术治疗胃癌安全、可行、有效、创伤小且近期效果良好。     

腹腔镜辅助与开腹远端胃癌根治术的临床对比研究

目的:探讨腹腔镜辅助远端胃癌根治术的可行性.方法:对39例行腹腔镜辅助远端胃癌粮治术(腹腔镜组)及40例开腹远端胃癌根治术(开腹组)患者的术后情况进行对比分析.结果:腹腔镜组与开腹组平均手术时间分别为(204.6±38.4)min和(166.1±36.8)min(P<0.05);但腹腔镜组术中出血量、术后恢复情况、术后外周血T淋巴细胞及NK细胞活性显著优于开腹组(P<0.05).腹腔镜组肿瘤根治程度、术后生存率、肿瘤复发情况与开腹组相比差异无统计学意义(P>0.05).结论:腹腔镜辅助远端胃癌根治术是安全可行的,其微创优势明显,能够达到与开腹手术相当的根治效果.     

腹腔镜辅助与开腹胃癌D2根治术的对比研究

目的探讨腹腔镜辅助胃癌D2根治术的可行性及近期疗效。方法2010年3月～2012年12月,施行361例胃癌D2根治术,2组医生分别手术,腹腔镜组166例,开腹组195例。对2组术中及术后情况、淋巴结清扫数目、并发症及病死率等进行比较。结果腹腔镜组手术时间[（241±55）min]、淋巴结清扫数[（29．8±6．5）个]与开腹组[（237±53）min、（30．5±7．0）个]差异无显著性（t=0．702、-0．978,P=0．438、0．329）,而腹腔镜组术中出血少[（115±59）ml vs．（259±121）ml,t=-13．981,P=0．000],术中输血例数少（7例 vs．19例,=4．098,P=0．043）,术后排气时间早[（3．6±0．9）dV8．（5．1±1．5）d,t=-11．271,P=0．000],首次进流质时间早[（6．1±1．3）dVS．（8．1±1．4）d,t=-13．977,P=0．000],术后住院时间短[（11．9±2．5）d VS．（14．3±3．2）d,t=-7．838,P=0．000]。腹腔镜组并发症发生率低[12．7％（21／166）VS．24．6％（48／195）,X^2=8．303,P=0．004],其中肺部感染的发生率明显低于开腹组[3．0％（5／166）vs．8．7％（17／195）,X^2=5．101,P=0．024]。结论腹腔镜辅助胃癌D2根治术具有安全可行、术后恢复快和并发症少等优点,同时在淋巴结清扫及近期预后方面能达到与开腹手术相同的效果。     

开腹与腹腔镜辅助远端胃癌根治术的临床对比研究

目的:对比开腹与腹腔镜辅助远端胃癌根治术的手术效果、围手术期恢复情况及预后,探讨腹腔镜辅助远端胃癌根治术的可行性及安全性。方法:选取2011年1月至2012年12月行远端胃癌根治术(远端胃切除+D2淋巴结清扫)的216例患者其分为两组,观察组行腹腔镜手术(n=104),対照组行开腹手术(n=112)。対比研究两组间的肿瘤生物学行为、手术时间、术中出血、术中淋巴结切除数量、术后胃肠道功能恢复时间、术后下床活动时间、术后并发症、住院时间、3年无瘤生存率。结果:两组在肿瘤生物学行为方面差异无统计学意义。观察组手术时间明显长于对照组(P0.05),术中出血量、淋巴结清扫数量、术后排气时间、术后下床活动时间及住院时间均优于对照组,差异有统计学意义(P0.05);术后并发症按Clavien-Dindo法分级并进行対比两组间差异无统计学意义(P0.05);3年无瘤生存率两组差异无统计学意义(P0.05)。结论:腹腔镜辅助下远端胃癌根治术是安全、可行的,与传统手术相比,在术中出血量、淋巴结清扫数量、术后恢复方面具有明显优势。     

腹腔镜与开腹胃癌D_2根治术的疗效分析

目的 评价腹腔镜与开腹胃癌D_2根治术治疗进展期胃癌的疗效.方法 回顾性分析2008年1月至2009年2月南京医科大学附属常州第二人民医院收治的64例腹腔镜胃癌D_2根治术患者(腹腔镜组)和60例同期行开腹胃癌D_2根治术患者(开腹组)的临床资料.采用t检验和X~2检验比较两组在手术时间,术中出血量,肿瘤近、远端切缘长度,淋巴结清扫数目,术后排气时间,下床活动时间,住院时间,并发症方面的差异.结果 两组患者均顺利完成胃癌D_2根治手术,腹腔镜组手术时间较开腹组长(t=5.56,P<0.05);腹腔镜组肿瘤的近、远端切缘长度和淋巴结清扫数目与开腹组比较,差异无统计学意义(t=0.67,0.86,1.09,P>0.05);腹腔镜组的术中出血量、排气时间、下床时间、住院时间,均显著少于开腹组(t=4.59,5.56,16.39,4.79,P<0.05).腹腔镜组有6例患者出现并发症,开腹组有5例患者出现并发症,两组并发症发生率比较差异无统计学意义(X~2=9.98,P>0.05).术后随访1～13个月,两组均无肿瘤复发及患者死亡.结论 腹腔镜胃癌D_2根治术安全、有效,能够达到理想的胃癌根治水平.     

腹腔镜与开腹胃癌根治术D2淋巴结清扫的比较研究

目的探讨腹腔镜下胃癌根治术D2淋巴结清扫的可行性。方法回顾性分析我科2007年1月～2009年3月手术治疗的110例胃癌的临床、病理资料。7例伴有远处转移,1例行腹腔镜下胃局部切除未行D2淋巴结清扫,根据排除标准予以剔除。其余102例行胃癌根治术(D2淋巴结清扫),包括近端胃大部切除+D2清扫术(PG+D2)25例,远端胃大部切除+D2清扫术(DG+D2)60例,全胃切除+D2清扫术(TG+D2)17例。102例根据手术方式分为腹腔镜组38例,开腹组64例。结果腹腔镜组清扫淋巴结数目(22.2±9.9个)与开腹组(23.4±9.4个)比较,差异无显著性(t=-0.651,P=0.514)。三种术式腹腔镜组清扫淋巴结数目与开腹组比较[PG+D2:19.4±7.3(n=8)vs21.2±8.5(n=17);DG+D2:20.9±10.8(n=22)vs22.2±8.0(n=38);TG+D2:28.3±7.5(n=8)vs32.8±12.1(n=9)],差异均无显著性(t=-0.517,-0.526,-0.913;P=0.610,0.601,0.375)。结论腹腔镜下胃癌根治D2淋巴结清扫是可行的,清扫淋巴结数目和开腹手术类似,能够符合肿瘤根治原则。     

腹腔镜胃癌根治术现状与展望

腹腔镜技术用于胃癌手术始于20世纪90年代，Ohgami等。于1994年首先报道了腹腔镜的局部胃切除治疗早期胃癌。Kitano等旧。于1994年首先报道了腹腔镜辅助下远端胃癌胃根治术，包括腹腔镜下胃周围血管离断、胃游离和小切口辅助下远端胃切除和消化道重建。Uyama等于1999年报道了腹腔镜下进展期胃癌根治术，包括腹腔镜下行全胃切除和D2淋巴结清扫。至2004年，日本已有7800例胃癌病人行腹腔镜胃癌手术。     

腹腔镜与开腹远端胃癌根治术的临床疗效对比及凝血功能变化分析

目的:对比腹腔镜与开腹远端胃癌根治术对远端胃癌患者的临床疗效。方法:将80例胃癌患者分为腹腔镜组和开腹组各40例,比较2组患者手术一般情况、术后恢复情况、T淋巴细胞亚群活性、N K细胞活性;并对2组患者术后凝血功能变化情况进行分析。结果:腹腔镜组手术时间明显高于开腹组,术中出血量、清除淋巴结数量显著低于开腹组,而肛门排气、排便以及下床活动时间均早于开腹组,2组相比差异具有统计学意义(P0.05);腹腔镜组C D 3+、C D 4+、C D 8+、C D 4+/C D 8+、N K细胞活性显著高于开腹组(P0.05)。2组患者术后活化部分凝血活酶时间(A PTT)、国际标准化比值(IN R)与术前相比差异无统计学意义(P0.05),而术后24 h 2组患者凝血酶原时间(PT)均显著缩短(P0.05)。手术结束时腹腔镜组患者血浆纤维蛋白原(FIB)、D-二聚体显著升高,术后24 h 2组患者FIB、D-二聚体均继续升高,与术前相比差异均有统计学意义(P0.05);其中开腹组手术结束时及术后24 h FIB、D-二聚体显著低于腹腔镜组(P0.05)。结论:腹腔镜胃癌根治术可以取得与开腹手术相当的近期疗效,但是术后血栓形成的风险更高,临床上需要在围手术期采取积极的预防措施。     

腹腔镜与开腹远端胃癌根治术的对比研究

目的比较完全腹腔镜下与开腹根治性远端胃大部切除术的术后早期疗效.方法回顾性分析2005年2月～2007年5月开展的44例腹腔镜下根治性远端胃大部切除术病例资料(腹腔镜组,LG),以同期46例开腹根治性远端胃大部切除术病例资料作为对照(开腹组,OG);比较两组病人的一般资料、手术风险(ASA)、pTNM分期、手术相关指数、切除范围、术后恢复时间及短期并发症的发生.结果两组之间的人口统计学指标、ASA值、pTNM分期、手术时间、淋巴结清除数、切缘长度及并发症发生率无明显差异(P＞0.05).但是LG术中出血量明显少于OG[(272±90)ml比(352±102)ml,P＜0.001],LG术后恢复肛门排气时间、进流质时间及进半流质时间明显早于OG(P＜0.05、P＜0.05及P＜0.05),术后住院时间亦明显缩短(P＜0.05).结论腹腔镜下远端胃癌根治术是安全可行的,能够满足肿瘤根治的严格要求,并且在术中失血、术后早期恢复饮食,缩短住院天数方面较开腹手术更有优势.     

Comparison of laparoscopically assisted and open radical distal gastrectomy with extended lymphadenectomy for gastric cancer management

Background The feasibility and safety of laparoscopically assisted gastrectomy with extended lymphadenectomy for advanced gastric cancer has rarely been studied. This study aimed to investigate the feasibility, safety, and cancer clearance of laparoscopically assisted distal gastrectomy with D2 lymphadenectomy. Methods Of the 44 patients with distal gastric cancer who underwent radical distal gastrectomy from March 2004 to May 2005, 35 were treated with D2/D2⁺ lymphadenectomy. These patients were compared with 58 patients who, during the same period, underwent a conventional open radical distal gastrectomy. Results The mean total number of retrieved lymph nodes (30.11 ± 16.97) and the mean tumor margin were comparable with those in the open group. The mean operative time for laparoscopically assisted distal gastrectomy was significantly longer than for open surgery (282.84 ± 32.81 min vs 223.75 ± 23.25 min). The patients in the laparoscopic surgery group had less blood loss, shorter times of analgesic injection, and a faster recovery. The rates of complications were comparable between two groups. Conclusions Although laparoscopically assisted radical gastrectomy with D2 lymphadenectomy is more time consuming than open surgery, it is a safe, feasible procedure that achieves cancer clearance similar to open surgery and leads to a quick postoperative recovery.     

腹腔镜辅助与开腹远端胃癌D2根治术的治疗效果比较

目的 探讨腹腔镜辅助远端胃癌D2根治术的治疗效果.方法 分析2008年11月至2011年10月行腹腔镜辅助和开腹远端胃癌D2根治术患者的临床资料,其中腹腔镜组61例,开腹组37例作为对照.结果 56例顺利完成腹腔镜手术,5例中转,手术时间:腹腔镜组(178.00±15.51) min,开腹组(147.86±17.41) min;术中出血量:腹腔镜组(138.43±39.67) ml,开腹组(362.86±59.86) ml(P＜0.05);平均切口长度:腹腔镜组(5.12±0.85)cm,开腹组(18.40±1.98) cm;两组在淋巴结清扫数量上差异无统计学意义(P＞0.05).开腹组术后发生5例肺部感染,腹腔镜组发生3例肺部感染,差异无统计学意义(P＞0.05).根据术后病检回报:两组均达到了癌肿的整块切除.规律随访得知所有患者均存活,未发现有远处转移.结论 腹腔镜辅助胃癌D2根治手术可以达到根治和微创的双重效果,其远期疗效有待进一步随访观察.     

Short-term efficacy of laparoscopy-assisted vs open radical gastrectomy in gastric cancer

AIM:To investigate the short-term benefits of laparoscopic radical gastrectomy(LARG)and open radical gastrectomy(ORG)in patients with gastric cancer.METHODS:A total of 400 patients with gastric cancer aged≤65 years who were treated at General Hospital of Lanzhou Military Region were enrolled.Among these,200 patients underwent LARG between October2008 and August 2012(LARG group);and 200 patients underwent ORG between March 2000 and September2008(ORG group).The short-term therapeutic benefits between the two groups were analyzed.RESULTS:The LARG procedure offered significantly better benefits to the patients compared to the ORG procedure,including less intraoperative blood loss(103.1±19.5 mL vs 163.0±32.9 mL,P0.0001),shorter postoperative hospital stay(6.8±1.2 d vs 9.5±1.6 d,P0.0001),less frequent occurrence of postoperative complications(6.5%vs 13.5%,P=0.02),shorter time to mobilization(1.0±0.3 vs 3.3±0.4 d,P0.0001),shorter time to bowel opening(3.3±0.7 d vs 4.5±0.7 d,P0.0001),and shorter time to normal diet(3.0±0.4 vs d 3.8±0.5 d,P0.0001).However,LARG required a longer time to complete than the ORG procedure(192.3±20.9 min vs 180.0±26.9 min,P0.0001).CONCLUSION:Compared to ORG,LARG is safer,more effective,and less invasive for treating gastric cancer,with better short-term efficacy.     

Laparoscopically assisted distal gastrectomy with standard radical lymph node dissection for gastric cancer

Background Laparoscopically assisted distal gastrectomy (LADG) with limited lymph node dissection (D1+alpha) has been used to treat a subset of patients with early gastric cancer. Technical advances have expanded indications for LADG to more advanced gastric cancers. However, little data are available on the feasibility or advantages of LADG with standard radical D2 lymph node dissection for patients with gastric cancer. Methods This study reviewed the clinical features of 37 patients who underwent LADG with D2 lymph node dissection for preoperatively diagnosed gastric carcinoma, then compared the results with the features of 31 patients who underwent conventional open distal gastrectomy (ODG) with D2 lymph node dissection. Results The laparoscopic procedure was not converted to laparotomy in any patient. There was no operative mortality and no serious morbidity among the patients who underwent LADG with D2 lymph node dissection. As compared with the ODG group, the LADG group had less operative blood loss (p < 0.001), earlier recovery of bowel activity (p = 0.012), and a shorter duration of fever after surgery (p = 0.015), despite the longer operation time (p = 0.007). Conclusions According to this study, LADG with D2 lymph node dissection is feasible and provides several advantages similar to those of limited lymph node dissection (D1+alpha). Depending on surgeons’ technical proficiency, LADG can be used with standard radical lymph node dissection for patients with gastric cancers.     

Meta-analysis of laparoscopy assisted distal gastrectomy and conventional open distal gastrectomy for EGC

In recent decades, laparoscopy assisted distal gastrectomy (LADG) has been introduced to treat early gastric cancer (EGC). This study evaluated the safety and efficacy of laparoscopy assisted and conventional open distal gastrectomy for EGC. Comprehensive searches of PubMed, EmBase, Cochrane Controlled Trials Register and Chinese Biomedical Database (CBM) were performed. Included literature was evaluated using the Newcastle-Ottawa Scale. Original data were extracted, pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated using RevMan 5.0. Eight RCTs of 734 patients were included in the study. Compared to CODG, LADG increases the operation time (weighted mean difference [WMD]: 63.35; 95% confidence interval [CI]: 57.96, 68.74; P < 0.01), reduces intraoperative blood loss (WMD: ?127.95; 95% CI: ?147.97, ?107.93; P < 0.01), decreases number of harvested lymph nodes (WMD: ?4.21; 95% CI: ?6.10, ?2.31; P < 0.01), forwards oral intake time (WMD:?0.43; 95% CI: ?0.61, ?0.24; P < 0.01), and shortens hospital stay(WMD: ?1.29; 95% CI: ?1.76, ?0.83; P < 0.01). There is no significant difference in postoperative complications(OR: 0.70; 95% CI: 0.46, 1.06; P = 0.09). All these findings indicate that LADG for EGC is feasible and safe.     

Intracorporeal esophagojejunal anastomosis after laparoscopic total gastrectomy for patients with gastric cancer

Background  To facilitate acceptance of laparoscopic total gastrectomy (LTG) for patients with upper gastric cancer, a simple, secure technique of reconstruction is necessary. The authors developed a new technique for intracorporeal esophagojejunal anastomosis that does not require hand sewing. Methods  From September 2006 to January 2008, 16 patients (11 men and 5 women) with gastric cancer underwent LTG at the authors’ institution. Laparoscopic esophagojejunal anastomosis using the following method was attempted for all patients. The esophagus was transected while being rotated by about 45° counterclockwise to make the subsequent anastomosis easier. After the Y-anastomosis was created, an endoscopic linear stapler was applied to create a side-to-side anastomosis between the left dorsal side of the esophagus and the jejunal limb. The entry hole was first closed roughly with hernia staplers. Subsequently, an endoscopic linear stapler was applied so that all hernia staplers could be removed and the closure completed. Results  Laparoscopic esophagojejunal anastomosis was successfully performed for 15 patients. Intracorporeal anastomosis failed for one patient because a nasogastric tube was caught between the jaws of an endostapler, which resulted in a conversion to open procedure. No postoperative anastomotic complications occurred. Conclusions  Using the new technique, intracorporeal linear-stapled esophagojejunal anastomosis can be performed easily and securely. This technique could become one of the standard methods for reconstruction after LTG, facilitating the acceptance of LTG as a surgical option for patients with upper gastric cancer.     

Comparison of outcomes for laparoscopically assisted and open radical distal gastrectomy with lymphadenectomy for advanced gastric cancer

Background  

Laparoscopically assisted gastric surgery has become an option for the treatment of early gastric cancer. However, the feasibility and safety of laparoscopically assisted gastrectomy for advanced gastric cancer has rarely been studied. This study evaluated the short- and long-term outcomes of laparoscopically assisted distal gastrectomy (LADG) for advanced gastric cancer.     

腹腔镜辅助下远端胃癌根治术与开放手术比较的临床研究

目的比较腹腔镜辅助下远端早、中期胃癌根治手术与传统开腹手术的疗效。方法回顾性分析我院2004年6月～2006年8月行腹腔镜辅助下根治性远端早、中期胃癌根治术19例及常规开腹远端早、中期胃癌根治术51例的临床资料。结果腹腔镜组19例均成功行腹腔镜辅助手术。腹腔镜手术和开放手术的平均时间分别为（194．5±23．21）min和（177．8±19．78）min,出血量分别为（182．4±40．21）ml和（346．8±33．98）ml,清扫淋巴结数量分别为（18．4±2．3）枚和（17．7±2．6）枚,术后肛门排气时间分别为第（4．31±1．28）d和第（4．89±1．62）d,平均住院时间分别为（14．3±2．5）d和（17．6±3．7）d,术后第1d平均白细胞计数分别为（8．79±3．54）×10^9／L和（10．43±2．78）×10^（／L。所有手术均无吻合口漏及术后死亡病例。结论腹腔镜辅助下胃癌根治术较传统开腹手术耗时长,但能达到胃癌标准根治术的淋巴结清扫范围,且具有出血少、住院时间短等优点。     

腹腔镜辅助胃癌根治术淋巴结清扫效果的临床对照研究

目的 探讨腹腔镜辅助胃癌根治术中淋巴结清扫的可行性及临床效果.方法 2007年1月至2010年5月,对934例胃癌患者施行根治性手术(RO切除),其中行腹腔镜手术患者(腹腔镜组)506例,行开腹手术患者(开腹组)428例.对比两组患者淋巴结清扫数目的 差异,并分析两组淋巴结清扫数目与术后并发症发生率的关系.结果 全部患者平均淋巴结清扫数目为(29±10)枚/例,两组平均淋巴结清扫数目相似(P＞0.05),但腹腔镜组No.7、8组淋巴结清扫数目明显多于开腹组(P＜0.05).按浸润深度分层分析,除pT3期腹腔镜组平均淋巴结清扫数目多于开腹组外,pT1-2期差异无统计学意义(P＞0.05);按淋巴结清扫范围和胃切除方式分层分析,腹腔镜组平均淋巴结清扫数目均与开腹组相当(P＞0.05);按手术时期分层分析,≤50例腹腔镜组平均淋巴结清扫数目少于开腹组(P＜0.05),51～100例和≥101例则与开腹组相当(P＞0.05).腹腔镜组并发症发生率为11.1%,明显低于开腹组的20.1%,但两组淋巴结清扫数目与术后并发症的相关性均无统计学意义(P＞0.05).结论 随着腹腔镜外科医师技术逐渐成熟,腹腔镜胃癌根治手术能够达到与开腹手术相当的淋巴结清扫效果;合理增加腹腔镜辅助胃癌根治术的淋巴结清扫数目不会增加术后并发症发生率.

Abstract：

Objective To explore the feasibility and efficacy of laparoscopy assisted radical gastrectomy on lymph node(LN)dissection for gastric cancer and to compare it with open gastrectomy.Methods The clinical data of 934 patients with gastric cancer underwent radical resection from January 2007 to May 2010 were analyzed retrospectively. Among the patients, 506 cases received laparoscopy assisted gastrectomy(LAG group)and 428 cases received open gastrectomy(OG group). The number of retrieved LNs and the survival curve between the two groups was compared. Then, the relations between the number of dissected LNs and postoperative morbidity were analyzed. ResultsFor all patients, the mean number of dissected LNs was 29±10, there was no significantly differences between LAG group and OG group(P＜0.05). While the number of the retrieved No. 7, 8 LNs in LAG group were significantly more than those in OG group. No significant differences was found in the number of dissected LNs for the pT1-2stages tumors between the two groups, but significantly greater number of LNs was harvested by LAG group in pT3 stage(P＜0. 05). No significant differences were found in the number of dissected LNs in different gastrectomy types or extents of LN dissection between the two groups. In the first 50 cases, there were less dissected LNs in LAG group than that in OG group, while 51 cases later, there was no significantly differences in number of dissected LNS between the two groups(P＞0.05). The postoperative morbidity of LAG group and OG group was 11.1% and 20. 1%, respectively(P ＜0.05), but there was no significant correlations between the number of dissected LNs and postoperative morbidity in both groups. Conclusions With the improvement in surgical skills, laparoscopy-assisted radical gastrectomy with lymph node dissection is a safe and feasible procedure, and it is oncologically compatible with open gastrectomy. Suitable increment of dissected LN count would not increase the postoperative complication rate.