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Surgical Endoscopy
Published in: Surgical Endoscopy 1/2013

01-01-2013

Laparoscopic versus open D2 gastrectomy for advanced gastric cancer: a retrospective cohort study

Authors: Toshihiko Shinohara, Seiji Satoh, Seiichiro Kanaya, Yoshinori Ishida, Keizo Taniguchi, Jun Isogaki, Kazuki Inaba, Katsuhiko Yanaga, Ichiro Uyama

Published in: Surgical Endoscopy | Issue 1/2013

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Abstract

Background

The oncologic safety and feasibility of laparoscopic D2 gastrectomy for advanced gastric cancer are still uncertain. The aim of this study is to compare our results for laparoscopic D2 gastrectomy with those for open D2 gastrectomy.

Methods

Between 1998 and 2008, a total of 336 patients with clinical T2, T3, or T4 tumors underwent laparoscopic (n = 186) or open (n = 150) gastrectomy involving D2 lymph node dissection with curative intent. To produce this study population, 123 patients in the open group who matched those of the laparoscopic group with regard to age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) score, tumor location, and clinical tumor stage were retrospectively selected. The short- and long-term outcomes of these patients were examined.

Results

Laparoscopic D2 gastrectomy was associated with significantly less operative blood loss and shorter hospital stay, but longer operative time, compared with open D2 gastrectomy. The mortality and morbidity rates of the laparoscopic group were comparable to those of the open group (1.1 % vs. 0, P = 0.519, and 24.2 % vs. 28.5 %, P = 0.402). The 5-year disease-free and overall survival rates were 65.8 and 68.1 % in the laparoscopic group and 62.0 and 63.7 % in the open group (P = 0.737 and P = 0.968). There were no differences in the patterns of recurrence between the two groups.

Conclusions

This study suggests that laparoscopic D2 gastrectomy provides reasonable oncologic outcomes with acceptable morbidity and low mortality rates. Although operation time is currently long, this approach is associated with several advantages of laparoscopic surgery, including quick recovery of bowel function and short hospital stay. Laparoscopic D2 gastrectomy may offer a favorable alternative to open D2 gastrectomy for patients with advanced gastric cancer.
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Metadata
Title
Laparoscopic versus open D2 gastrectomy for advanced gastric cancer: a retrospective cohort study
Authors
Toshihiko Shinohara
Seiji Satoh
Seiichiro Kanaya
Yoshinori Ishida
Keizo Taniguchi
Jun Isogaki
Kazuki Inaba
Katsuhiko Yanaga
Ichiro Uyama
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 1/2013
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-012-2442-x

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