Outcome of laparoscopy-assisted gastrectomy vs. open gastrectomy for gastric cancer: a retrospective comparative study

Hepatogastroenterology. 2012 May;59(115):938-41. doi: 10.5754/hge11039.

Abstract

Background/aims: 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.

Methodology: 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.

Results: 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.

Conclusions: Laparoscopy-assisted gastrectomy with D2 lymph node dissection is a safe and feasible procedure with adequate lymphadenectomy for the treatment of gastric cancer.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • China
  • Feasibility Studies
  • Female
  • Gastrectomy / adverse effects
  • Gastrectomy / methods*
  • Gastrectomy / mortality
  • Humans
  • Kaplan-Meier Estimate
  • Laparoscopy* / adverse effects
  • Laparoscopy* / mortality
  • Logistic Models
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Time Factors
  • Treatment Outcome