Abstract
BackgroundGastric cancer is a common malignancy worldwide and a common cause of death from cancer. Despite recent advances in multimodality treatment and targeted therapy, complete resection remains the only treatment that can lead to cure. This study was devised to investigate the technical feasibility, safety and oncologic efficacy of laparoscopy-assisted gastrectomy for advanced gastric cancer without serosa invasion.MethodsA retrospective matched cohort study was performed in south China comparing laparoscopy-assisted gastrectomy and open gastrectomy for advanced gastric cancer without serosa invasion. Eighty-three patients with advanced gastric cancer undergoing laparoscopy-assisted gastrectomy between January 2008 and December 2010 were enrolled. These patients were compared with 83 patients with advanced gastric cancer undergoing open gastrectomy during the same period.ResultsThere was no significant difference in clinicopathologic characteristics between the two groups. Regarding perioperative characteristics, the operation time and time to ground activities did not differ between the two groups, whereas the blood loss, transfused patient number, time to first flatus, time to resumption of diet, and postoperative hospital stay were significantly less in laparoscopy-assisted gastrectomy than in open gastrectomy (P <0.05). There was no statistically significant difference in postoperative morbidity and mortality. No significant difference in the number of lymph nodes dissected was observed between these two groups. There was no significant difference in the cumulative survival rate between the two groups.ConclusionLaparoscopy-assisted gastrectomy with D2 lymphadenectomy is a safe and feasible procedure for advanced gastric cancer without serosa invasion. To be accepted as a choice treatment for advanced gastric cancer, well-designed randomized controlled trials comparing short-term and long-term outcomes between laparoscopy-assisted gastrectomy and open gastrectomy in a larger number of patients are necessary.
Highlights
Gastric cancer is a common malignancy worldwide and a common cause of death from cancer
We describe our experience with laparoscopy-assisted gastrectomy (LAG) in the treatment of advanced gastric cancer (AGC) without serosa invasion, and evaluate the feasibility, safety and oncologic aspect of this approach through a matched cohort study
There was no statistically significant difference found in the majority of the demographic parameters between the two patient populations (Table 1)
Summary
Gastric cancer is a common malignancy worldwide and a common cause of death from cancer. This study was devised to investigate the technical feasibility, safety and oncologic efficacy of laparoscopy-assisted gastrectomy for advanced gastric cancer without serosa invasion. A common malignancy worldwide, is the second most common cause of death from cancer [1]. Despite recent advances in multimodality treatment and targeted therapy, complete resection remains the only treatment that can lead to cure. Application of laparoscopic techniques for advanced gastric cancer (AGC) remains controversial because of the technical difficulty of extragastric lymphadenectomy and insufficient data related to the procedure’s oncologic adequacy. We describe our experience with laparoscopy-assisted gastrectomy (LAG) in the treatment of AGC without serosa invasion, and evaluate the feasibility, safety and oncologic aspect of this approach through a matched cohort study
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