Oncologic outcomes of laparoscopic gastrectomy: a single-center safety and feasibility study

Surg Endosc. 2013 Jun;27(6):1973-9. doi: 10.1007/s00464-012-2696-3. Epub 2013 Mar 7.

Abstract

Background: Indications for laparoscopic gastrectomy (LG) for early stomach cancer have spread worldwide and evaluation of short-term outcomes has been favorable. The present study aimed to evaluate both technical feasibility and safety of LG and short-and long-term outcomes after LG.

Methods: The study group comprised 231 patients who underwent LG during the period from August 2001 through December 2011 at Gifu University School of Medicine.

Results: Concomitant resection of other organs was performed in 16 (6.9 %) of the 231 patients, and conversion to open surgery was performed in 5 (2.2 %) patients. The final clinical stage of the patients, according to the Union for International Cancer Control classification, was stage IA in 183 (79.0 %), stage IB in 26 (11.3 %), stage IIA in 9 (2.6 %), stage IIB in 6 (2.6 %), stage IIIA in 5 (2.2 %), and stage IIIB in 2 (0.9 %) patients. Average values of total blood loss and operation time were 133.7 ± 129.0 ml and 328.1 ± 70.1 min, respectively. Postoperative complications were detected in 29 patients (12.6 %), and one patient died. According to the Clavien-Dindo classification of surgical complications, the rate of severe complications of grade ≥ 3a was 6.1 % and that of grade ≥ 3b was 1.3 %. There were no significant differences in complications in relation to clinicopathological or operative procedures. Cancer recurrence was detected in 2 (0.9 %) patients. In the patient with peritoneal dissemination, tumor size and macroscopic type were critical. Five-year overall survival rates were 99.3 % for stage IA, 95.2 % for stage IB, and 50.0 % for stage IIB patients. One recurrence each was detected for stages IA and IIB cancers.

Conclusion: The present study showed LG to have a safe postoperative course and to benefit oncologic outcomes.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Conversion to Open Surgery / statistics & numerical data
  • Feasibility Studies
  • Female
  • Gastrectomy / adverse effects
  • Gastrectomy / methods*
  • Humans
  • Kaplan-Meier Estimate
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Length of Stay
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / etiology
  • Postoperative Complications / etiology*
  • Stomach Neoplasms / surgery*
  • Treatment Outcome