Comparison of Laparoscopic and Open Gastrectomy on Cancer Cells Exfoliating From the Cancer-invaded Serosa

Abstract

Whether laparoscopic gastrectomy may reduce the frequency of gastric cancer cells exfoliating from the cancer-invaded serosa remains unclear. This study aimed to compare the detection of free gastric cancer cells in the peritoneal cavity during laparoscopic and open gastrectomy. Intraoperative peritoneal washings were collected from 63 gastric cancer patients undergoing laparoscopic gastrectomy and 61 patients undergoing open surgery. Hematoxylin and eosin staining and real time reverse transcription-polymerase chain reaction were used to examine the free cancer cells. The postoperative positive rates of free cancer cells detected by cytologic and real time reverse transcription-polymerase chain reaction were 39.68% and 44.26% in the laparoscopic and open groups, respectively. The depth of tumor invasion, area of invaded serosa, regional lymph node involvement, and higher tumor node metastasis staging were significantly associated with the presence of free cancer cells. The laparoscopic techniques used in gastric cancer surgery were not associated with a greater risk for the intraperitoneal dissemination of cancer cells than conventional techniques.