Abstract
Laparoscopy-assisted gastrectomy is still controversial because of scant evidence of safety and feasibility. The objective of this study was to assess the feasibility of using the laparoscopy-assisted gastrectomy in treating gastric cancer and evaluate its outcome compared with conventional open gastrectomy. Between November 2005 and November 2007, 31 patients underwent laparoscopy-assisted gastrectomy and 95 patients underwent open gastrectomy for gastric cancer. Clinicopathological characteristics, total number of lymph nodes retrieved and overall survival were retrospectively compared between the two groups. No significant differences were found in the total number of retrieved lymph nodes (26.3±11.6 vs. 27.6±10.4) between the two groups. The mean follow-up and overall survival time after surgery was 30.8 (range 4-47) months and 40.9 months (95% confidence interval, 38.5-43.2 months), respectively. The mean survival time in patients of the laparoscopy-assisted gastrectomy group was 42.4 months vs. 40.3 months in patients of the open surgery alone group (p=0.457). A logistic regression model revealed that node invasion (hazard ratio 1.149, p<0.001) and serosal invasion (hazard ratio 4.623, p=0.044) were associated with overall survival of gastric cancer patients. Laparoscopy-assisted gastrectomy with D2 lymph node dissection is a safe and feasible procedure with adequate lymphadenectomy for the treatment of gastric cancer.
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