OBJECTIVETo investigate the effect of operative time on laparoscopy-assisted distal gastrectomy (LADG) with D2 lymph node dissection and the influencing factors of operative time.

METHODSClinical data of 332 patients with gastric cancer undergoing LADG with D2 lymph node dissection from January 2007 to December 2010 were analyzed retrospectively. The average operative time was (205±56) minutes. Operative indices and postoperative recovery were compared between patients with operative time≥205 min (long-time group) and operative time<205 min (short-time group).

RESULTSThe mean blood loss [(81.0±65.7) ml vs. (65.8±55.0) ml], time to ambulation [(3.1±1.7) d vs. (2.3±1.2) d], time to first flatus [(3.8±1.1) d vs. (3.2±1.3) d], postoperative hospital stay [(14.2±6.3) d vs. (12.5±7.0) d], and postoperative complication [16.0% (19/119) vs. 8.5% (18/213)] between long-time group and short-time group were significantly different (all P<0.05), while there were no significant differences in transfused patients, time to resume soft diet, and mortality (all P>0.05). Multivariate logistic regression analysis revealed that BMI (P<0.01), lymph node metastasis (P<0.05), and surgeon experience (P<0.01) were independent risk factors for operation time.

CONCLUSIONSurgeons who have limited experience in LADG with D2 lymph node dissection should operate on patients with low BMI and less lymph node metastasis in order to reduce postoperative complications.