National Trend in Laparoscopic Gastrectomy for Gastric Cancer: Analysis of the National Register in Chile

Dig Surg. 2018;35(5):461-468. doi: 10.1159/000485197. Epub 2018 Apr 17.

Abstract

Introduction: The laparoscopic approach for the treatment of gastric cancer has many advantages. However, outside Asia there are few large case series.

Aim: To evaluate postoperative morbidity, long-term survival, changes in indication, and the results of laparoscopic gastrectomy.

Methods: We included all patients treated with a laparoscopic gastrectomy from 2005 to 2014. We compared results across 2 time periods: 2005-2011 and 2012-2014. Median follow-up was 39 months.

Results: Two hundred and eleven patients underwent a laparoscopic gastrectomy (median age 64 years, 55% male patients). In 135 (64%) patients, a total gastrectomy was performed. Postoperative morbidity occurred in 29%. A significant increase in the indication of laparoscopic surgery for stages II-III (32 vs. 45%; p = 0.04) and higher lymph node count (27 vs. 33; p = 0.002) were observed between the 2 periods. The 5-year overall survival was 72%. According to the stage, the 5-year overall survival was 85, 63, and 54% for stage I, II, and III respectively (p < 0.001).

Conclusions: There was an acceptable rate of postoperative complications and the long-term survival was in accordance with the disease stage. There was a higher indication of laparoscopic surgery in stages II-III disease, and higher lymph node count in the latter period of this study.

Keywords: Gastrectomy; Laparoscopy; Stomach neoplasms.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chile
  • Female
  • Gastrectomy / adverse effects
  • Gastrectomy / methods
  • Gastrectomy / trends*
  • Humans
  • Laparoscopy* / adverse effects
  • Length of Stay / trends
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Operative Time
  • Patient Selection
  • Postoperative Complications / etiology
  • Registries
  • Retrospective Studies
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery*
  • Survival Rate / trends
  • Young Adult