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Short-term and Long-term Outcomes Following Laparoscopic Gastrectomy for Advanced Gastric Cancer Compared With Open Gastrectomy

Shibuya, Kazuaki MD*; Kawamura, Hideki MD, PhD*; Takahashi, Shusaku MD, PhD; Ohno, Yosuke MD, PhD*; Ichikawa, Nobuki MD, PhD*; Yoshida, Tadashi MD, PhD*; Homma, Shigenori MD, PhD*; Ishizu, Hiroyuki MD, PhD; Takahashi, Masahiro MD, PhD; Taketomi, Akinobu MD, PhD*

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: August 2019 - Volume 29 - Issue 4 - p 297–303
doi: 10.1097/SLE.0000000000000660
Original Articles
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Introduction: To investigate the oncological feasibility and technical safety of laparoscopic gastrectomy with D2 lymphadenectomy for advanced gastric cancer.

Methods: A total of 186 advanced gastric cancer patients treated by gastrectomy with D2 lymphadenectomy were eligible for inclusion including those with invasion into the muscularis propria, subserosa, and serosa without involvement of other organs, and stages N0-2 and M0. We retrospectively compared the short-term and long-term outcomes between laparoscopic gastrectomy and open gastrectomy.

Results: We analyzed short-term outcomes by comparing distal with total gastrectomy results. We found no significant difference for distal gastrectomy for postoperative morbidity [laparoscopic vs. open: n=4 (4.6%) vs. n=1 (3.6%); P=1.00]. We also found no significant difference in postoperative morbidity for total gastrectomy [laparoscopic vs. open: n=2 (4.0%) vs. n=1 (4.0%); P=1.00]. No deaths occurred in any group.

The entire cohort analysis revealed no statistically significant differences in overall-free or recurrence-free survival between the laparoscopic and open groups. For overall survival, there were no significant differences between open and laparoscopic groups for clinical stage II or III (P=0.29 and 0.27, respectively), and for pathologic stage II or III (P=0.88 and 0.86, respectively). For recurrence-free survival, there were no significant differences between open and laparoscopic groups for clinical stage II or III (P=0.63 and 0.60, respectively), and for pathologic stage II or III (P=0.98 and 0.72, respectively).

Conclusion: Laparscopic gastrectomy for advanced gastric cancer compared favorably with open gastrectomy regarding short-term and long-term outcomes.

*Department of Gastroenterologic Surgery, Hokkaido University Hospital

Department of Surgery, Hokkaido P.W.F.A.C. Sapporo Kosei General Hospital, Sapporo, Japan

The authors declares no conflicts of interest.

Reprints: Hideki Kawamura, MD, PhD, Department of Gastroenterological Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan (e-mail: h.kawamura@med.hokudai.ac.jp).

Received September 17, 2018

Accepted February 1, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.