The Effect of Neoadjuvant Chemotherapy Combined with Laparoscopic Surgery on the Prognosis of Advanced Gastric Cancer

LIU Qi; YUAN Bo; DU Ying-lian

摘要：Objective: To investigate the effect of neoadjuvant chemotherapycombined with laparoscopic surgery on the prognosis of advanced gastric cancer. Methods: From January 2014 to January 2016, 96 patients with advanced gastric cancer were selected from the general surgery department of the Fourth People's Hospital of Haikou. All patients underwent laparoscopic radical gastrectomy. According to the wishes of patients and their families, patients were divided into study group and control group, 48 cases in each group. The control group received laparoscopic gastrectomy, and the study group received laparoscopic gastrectomy after neoadjuvant chemotherapy. To analyze the curative effect and adverse reactions of the patients in the study group after chemotherapy;to compare the perioperative indexes and the incidence of postoperative complications of the two groups, and to compare the R0 resection rate of the two groups. The patients were followed up to find out the postoperative survival, and the 1-year, 2-year and 3-year survival rates of the two groups were compared. Results:All patients in the study group completed three courses of chemotherapy without interruption or stop. After chemotherapy, the objective response rate (ORR) was 45.83％, and the clinical benefit rate (CBR) was 93.75％. Most of the adverse reactions of chemotherapy were grade Ⅰ-Ⅱ, and the symptoms were relieved after the symptomatic treatment, and the patients could tolerate it. There was no significant difference between the two groups (P>0.05). The main postoperative complications of the two groups were incision infection, lung infection, abdominal infection, intestinal obstruction, anastomotic leakage, lower extremity deep vein thrombosis, and gastric emptying disorder. The incidence of postoperative complications in the study group was 20.83％, no significant difference compared with 25.00％in the control group (P>0.05). The removal rate of R0 in the study group was 81.25％, significantly higher than that in the control group (45.83％) (P<0.05). The 1-year, 2-year and 3-year survival rates of the study group were higher than those of the control group, the difference was statistically significant (P<0.05). Conclusion:Neoadjuvant chemotherapy before laparoscopic resection of advanced gastric cancer can improve the resection rate of R0 and the survival rate of the patients, which has no significant effect on the perioperative indexes and complications of laparoscopic surgery.