Abstract
145 Background: The application of laparoscopy in the surgical treatment of gastric cancer has become more popular in recent years. Most of the published series are from Asia and few report on survival. Our objective was to elucidate the safety, efficacy, and oncologic outcomes of laparoscopic distal gastrectomy in patients with gastric cancer. Methods: The medical records of all patients who underwent laparoscopic distal gastrectomy at City of Hope National Medical Center between 6/2005 and 8/2010 were retrospectively reviewed. Relevant data analyzed included patient demographics, operative parameters, complications, recurrence, and survival. Results: A total of 38 consecutive patients were identified. Thirty-four of the 38 patients had a diagnosis of gastric adenocarcinoma. Median age was 70 years (35-96). Median operative time was 379 min (228-583). Median EBL was 200 ml (10-900). Seventeen of the 38 laparoscopic distal gastrectomy cases employed robotic assistance in lymph node dissection. The median number of lymph node retrieval was 23.5. Twenty-two cases included D2 lymph node dissections, 14 cases were D1 dissections, and 2 cases involved D0 dissections. All intended D2 dissections had greater than 15 nodes retrieved. Median hospital stay was 6 days (3-39). Morbidity and mortality rates were 11% and 0%, respectively. Of the 34 patients with gastric adenocarcinoma, histological staging revealed 1 patient had stage 0 disease, 25 had stage I, 7 had stage II, and 2 had stage III. Median follow-up was 12 months (0.5 to 58). Cancer recurrence occurred in 2 patients (6%). The 3 year overall survival is 69% and disease specific survival is 90%. The median survival has not been reached. Conclusions: Laparoscopic distal gastrectomy is feasible and safe and can be performed in patients with gastric cancer with excellent surgical and oncologic outcomes. No significant financial relationships to disclose.
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