Differences Regarding the Laparoscopic and Laparotomic D2 Lymphadenectomy for the Surgical Treatment of Gastric Adenocarcinoma A Literature Review

Abstract

Introduction:The gastric adenocarcinoma is currently the most common histological type of gastric cancer, being diagnosed in 95% of the cases of gastric tumors. Lymphomas, sarcomas and gastrointestinal stromal tumors comprise the remaining 5%. Objective: This study aims to analyze, evaluate and compare the existing evidences regarding D2 lymphadenectomy performed laparoscopically or conventionally (laparotomically) during the treatment of gastric adenocarcinoma. Methodology: The current study is based on literary review of publications from the databases SciELO, LILACS and PubMED. The research was made using "gastric cancer", "Laparoscopic gastrectomy" and "open gastrectomy" as keywords. Discussion: The surgical approach is the standard treatment, and its execution relies on the patient's performance status. For the gastric adenocarcinoma, the surgical treatment of choice, and usually the most suitable, is the radical resection, respecting the safety margins for complete resection, as well as excision of epiplon and regional lymph nodes. Currently, the D2 lymphadenectomy is considered the standard treatment of gastric adenocarcinoma. Conclusion:It is seen that the resected lymph nodes seen in laparoscopic approaches are in greater number than the ones resected during a lymphadenectomy performed via laparotomy, the D2 lymphadenectomy performed via laparoscopy was as efficient as the one performed conventionally. Despite controversies in the past regarding the comparison between the laparoscopic procedure and open surgery, recent studies have shown good efficacy of the procedure and demonstrate reduction of complications and survival rates maintained or improved.