Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer: early and long-term results of a 100-patient series |
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Authors: | Huscher Cristiano G S Mingoli Andrea Sgarzini Giovanna Brachini Gioia Binda Barbara Di Paola Massimiliano Ponzano Cecilia |
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Institution: | Department of Health Sciences, Division of Surgery, Veneziale Hospital, Molise University, Isernia, Italy. |
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Abstract: | BACKGROUND: Controversies exist about feasibility and oncologic effectiveness of laparoscopic gastrectomies with extended lymphadenectomy for advanced gastric cancer. The aim of our study was to determine if long-term results of these laparoscopic procedures may justify their use as an alternative to open surgery also in advanced gastric cancer. METHODS: We performed a retrospective review of 100 patients after laparoscopic surgery for gastric cancer. RESULTS: Tumor stage (S) was SIA in 21 patients, SIB in 20, SII in 17, SIIIA in 17, SIIIB in 5, and SIV in 20. Eleven total and 89 subtotal R0 gastrectomies were performed. The mean number of dissected lymph nodes was 35 +/- 18. The conversion rate was 3%. Surgical mortality and major morbidity were 6% and 13%, respectively. Overall and disease-free 5-year survival rates were 59% and 57%, respectively. CONCLUSIONS: Laparoscopic gastrectomy with extended lymphadenectomy for early and advanced gastric cancer is feasible, safe, and oncologically effective. Long-term survival rates are similar to those observed after open surgery. |
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Keywords: | Laparoscopic surgery Total gastrectomy Subtotal gastrectomy Lymph node dissection Advanced gastric cancer |
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