Surgical and Long-Term Survival Outcomes After Laparoscopic and Open Total Gastrectomy for Locally Advanced Gastric Cancer: A Propensity Score-Matched Analysis.

Abstract

To compare the surgical and long-term survival outcomes of laparoscopic and open total gastrectomy (OTG) for locally advanced gastric cancer (AGC). We retrospectively evaluated 308 and 900 patients in pathological locally AGC who underwent laparoscopic total gastrectomy (LTG) or OTG between June 2008 and December 2014. We compared surgical and long-term outcomes between the two groups using propensity score matching method. The LTG group showed a longer operation time (261.42 vs. 171.00min, P = 0.001), less blood loss (185.47 vs. 217.84ml, P = 0.000), earlier time to first flatus (3.47 vs. 4.12days, P = 0.000), earlier time to start liquid diet (3.76 vs. 4.27days, P = 0.000), and shorter postoperative hospital stay (7.56 vs. 8.22days, P = 0.007). The overall complication rate was 15.2% in the LTG group and 17.2% in the OTG (P = 0.503). No significant difference was observed in overall survival (OS) and disease-free survival (DFS) between LTG and OTG (60.5% vs. 57.1%, P = 0.337; 57.4% vs. 54.4%, P = 0.341). Compared to OTG, LTG provides surgical benefits and comparable survival outcomes for patients with locally AGC.