Short and long-term outcomes of laparoscopic total gastrectomy for gastric cancer: A single-center experience (retrospective cohort study)

Abstract

BackgroundLimited studies have been designed to evaluate the short and long-term outcomes of laparoscopic total gastrectomy (LTG). The objective of this study was to evaluate the feasibility, safety, and oncological outcomes of LTG. MethodsA total of 290 consecutive patients underwent radical gastrectomy for gastric cancer in our institution between 2010 and 2016, from which 110 were performed laparoscopically and included in the study. Short and long-term outcomes of LTG, such as operative results, postoperative courses, morbidities, and mortality, were investigated and compared with those of laparoscopy distal gastrectomy (LDG) patients. ResultsFrom the total of 110 patients who underwent LTG, no one underwent conversion. The mean operation time was 267 ± 88 min. The mean reconstruction time was 45.3 ± 15 min, and the mean intraoperative blood loss was 75.4 ± 20 ml. The time until the first flatus was 4 ± 1.5 days. The time to start soft diet was 7 ± 1.8 days. The length of postoperative hospital stay was 9 ± 2 days. The mean number of retrieved lymph nodes was 34.7 ± 9. Compared with the LDG group, the mean operation time, the mean reconstruction time, number of retrieved lymph nodes, and time of start soft diet were significantly longer in the LTG group (P＜0.05).The postoperative complication rates of the LTG group and LDG group were 10% and 8.3% (P＞0.05), respectively. The 3-year cumulative survival rates of the LTG group and LDG group were 53.8% and 56.6% (P = 0.21), respectively. ConclusionLTG for gastric cancer is a safe, reliable and minimally invasive procedure with short and long-term outcomes similar to those of LDG.