Feasibility and Safety of Totally Laparoscopic Radical Gastrectomy for Advanced Gastric Cancer: Comparison with Early Gastric Cancer.
- Author:
Seungyeob LEE
1
;
Hayemin LEE
;
Junhyun LEE
Author Information
- Publication Type:Original Article
- Keywords: Stomach neoplasms; Gastrectomy; Laparoscopy; Lymph node excision
- MeSH: Disease-Free Survival; Gastrectomy*; Humans; Laparoscopy; Length of Stay; Lymph Node Excision; Lymph Nodes; Mortality; Stomach Neoplasms*; Surgeons
- From:Journal of Gastric Cancer 2018;18(2):152-160
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Totally laparoscopic gastrectomy (TLG) for advanced gastric cancer (AGC) is a technically and oncologically challenging procedure for surgeons. This study aimed to compare the oncologic feasibility and technical safety of TLG for AGC versus early gastric cancer (EGC). MATERIALS AND METHODS: Between 2011 and 2016, 535 patients (EGC, 375; AGC, 160) underwent curative TLG for gastric cancer. Clinicopathologic characteristics and surgical outcomes of both patient groups were analyzed and compared. RESULTS: Patients with AGC required a longer operation time and experienced more intraoperative blood loss than those with EGC did. However, patients from both the AGC and EGC groups demonstrated similar short-term surgical outcomes such as postoperative morbidity (14.4% vs. 13.3%, P=0.626), mortality (0% vs. 0.5%, P=0.879), time-to-first oral intake (2.7 days for both groups, P=0.830), and postoperative hospital stay (10.2 days vs. 10.1 days, P=0.886). D2 lymph node dissection could be achieved in the AGC group (95%), with an adequate number of lymph nodes being dissected (36.0±14.9). In the AGC group, the 3-year overall and disease-free survival rates were 80.5% and 73.7%, respectively. CONCLUSIONS: TLG is as safe and effective for AGC as it is for EGC.
