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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2015

01-10-2015 | Gastrointestinal Oncology

Laparoscopic Versus Open Gastrectomy for Gastric Adenocarcinoma in the West: A Case–Control Study

Authors: Kaitlyn J. Kelly, MD, Luke Selby, MD, Joanne F. Chou, MPH, Katerina Dukleska, MD, Marinela Capanu, PhD, Daniel G. Coit, MD, Murray F. Brennan, MD, Vivian E. Strong, MD

Published in: Annals of Surgical Oncology | Issue 11/2015

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Abstract

Introduction

Data on laparoscopic gastrectomy in patients with gastric cancer in the Western hemisphere are lacking. This study aimed to compare outcomes following laparoscopic versus open gastrectomy for gastric adenocarcinoma at a Western center.

Methods

Eighty-seven consecutive patients who underwent laparoscopic gastrectomy from November 2005 to April 2013 were compared with 87 patients undergoing open resection during the same time period. Patients were matched for age, stage, body mass index, and procedure (distal subtotal vs. total gastrectomy). Endpoints were short- and long-term perioperative outcomes.

Results

Overall, 65 patients (37 %) had locally advanced disease, and 40 (23 %) had proximal tumors. The laparoscopic approach was associated with longer operative time (median 240 vs.165 min; p < 0.01), less blood loss (100 vs.150 mL; p < 0.01), higher rate of microscopic margin positivity (9 vs.1 %; p = 0.04), decreased duration of narcotic and epidural use (2 vs. 4 days, p = 0.04, and 3 vs. 4 days, p = 0.02, respectively), decreased minor complications in the early (27 vs. 16 %) and late (17 vs. 7 %) postoperative periods (p < 0.01), decreased length of stay (5 vs. 7 days; p = 0.01), and increased likelihood of receiving adjuvant therapy (82 vs. 51 %; p < 0.01). There was no difference in the number of lymph nodes retrieved (median 20 in both groups), major morbidity, or 30-day mortality.

Conclusions

Laparoscopic gastrectomy for gastric adenocarcinoma is safe and effective for select patients in the West.
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Metadata
Title
Laparoscopic Versus Open Gastrectomy for Gastric Adenocarcinoma in the West: A Case–Control Study
Authors
Kaitlyn J. Kelly, MD
Luke Selby, MD
Joanne F. Chou, MPH
Katerina Dukleska, MD
Marinela Capanu, PhD
Daniel G. Coit, MD
Murray F. Brennan, MD
Vivian E. Strong, MD
Publication date
01-10-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 11/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4381-y

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