Hand-assisted laparoscopic versus open surgery radical gastrectomy for advanced distal gastric cancer: a prospective randomized study

Background: This study aims to comparative treatment outcomes of hand-assisted laparoscopic surgery (HALS) versus open surgery (OS) in radical gastrectomy of advanced distal gastric cancer. Methods: This was a prospective randomized controlled study of 124 patients who underwent radical treatment for advanced distal gastric cancer from May 2008 and April 2012. Among them, the patients were divided into a HALS group (n = 62) and an OS group (n = 62), and to compare the short-term and long-term outcomes between two groups. Results: All subjects in the two groups completed the surgery. Compared to the OS group, the HALS group exhibited a smaller incision size (P<0.001), lower intraoperative bleeding level (P = 0.009), and shorter postoperative anal exhaust time (P = 0.025), although the two groups showed no differences in the surgical duration, incidence of perioperative complications, or mortality rate and the surgical outcome. An examination of the long-term outcomes revealed that the two groups exhibited no differences in one-year survival, three-year survival, disease-free survival, or quality of life scores. Conclusion: HALS is a safe and feasible treatment for advanced distal gastric cancer and features advantages such as a small surgical incision, low intraoperative bleeding, and quick postoperative recovery of gastrointestinal function. Importantly, its long-term efficacy is similar to that of OS.