Long‐term outcomes after laparoscopy‐assisted gastrectomy for advanced gastric cancer: Analysis of consecutive 106 experiences

Abstract

Background and Objectives: The purpose of this retrospective study is to suggest the possibility of laparoscopy-assisted gastrectomy (LAG) for advanced gastric cancer (AGC) through long-term outcomes. Methods: Of 283 patients with gastric cancer who underwent LAG with extraperigastric (D2) lymphadenectomy between January 2004 and February 2009, 106 were pathologically confirmed with AGC and analyzed. Results: There were 75 men and 31 women, with a mean age of 61.4 AE 11.7 years. There were 32 total gastrectomies and 74 distal gastrectomies with D2 lymphadenectomy. The mean tumor size was 4.8 AE 2.6 cm. The mean numbers of retrieved and metastatic lymph nodes were 34.3 AE 15.3 and 5.4 AE 8.7, respectively. There was no lymph node metastasis in 44 patients (41.5%), and there were 35 grade T2a, 51 T2b, and 20 T3 lesions. There were 10 operation-related morbidities (9.4%) and one postoperative death (0.9%) from hepatic failure. The overall and disease-free survival rates were 81.4% and 72.4%, respectively. Tumors recurred in 17 patients (16.0%) during the follow-up periods (median 21.5 months; range 2-60). Conclusions: LAG for AGC might be considered as a minimally invasive treatment in selected cases, but further study comparing it with open gastrectomy will be needed.

Clinical Outcome and Clinicopathological Characteristics of Recurrence after Laparoscopic Gastrectomy for Advanced Gastric Cancer

“…The results of the present study indicate there was neither a port-site recurrence nor an increased incidence of recurrence and are in fact in contrast to the previous report. Although long-term outcomes after laparoscopic gastrectomy for patients with advanced gastric cancer have been reported [14,15], previous reports concerning the precise recurrence patterns after laparoscopic gastrectomy have been limited [3]. In particular, it has classically been suggested that insufflated carbon dioxide gas used for pneumoperitoneum could possibly facilitate port-site recurrence and peritoneal dissemination [16].…”

Comparative study of laparoscopicvsopen gastrectomy in gastric cancer management

“…However it has to be said that many case series have been recently published showing adequate resection margins and lymph nodes retrieval for LGS in AGC whilst long term results still lack of comfortable numbers [13][14][15][16] .…”

Minimalinvasive Chirurgie bei Malignomen des Gastrointestinaltrakts: Magen - Kontra-Position

“…Die Daten zum Langzeitüberleben sind spärlich [12,14,28]. Das maximale Follow-up innerhalb der randomisierten Studien aus Asien liegt bei 39 Monaten median für das laparoskopische Vorgehen [12].…”

“…laparoskopisch assistierten Gastrektomien, um die Lernkurve abzuschließen, variiert in der Literatur zwischen 20 und 300 [11,15,28]. Die Zahlen bezüglich der Lernkurve für laparoskopische Magenchirurgie sind häufig auch an die Erfahrung in der offenen Chirurgie geknüpft.…”