Videolaparoscopic total and subtotal gastrectomy with extended lymph node dissection for gastric cancer.

Background: Laparoscopic surgery has been used in the treatment of early gastric cancer with low mortality and morbidity and improvement in patient's quality of life. The purpose of the current study was to determine if these advantages persist after radical laparoscopic treatment of more advanced gastric cancer.

Methods: A retrospective review of 44 patients after laparoscopic surgery for gastric cancer was performed.

Results: Tumor stage was IA in 8 patients, IB in 12, II in 9, IIIA in 6, IIIB in 1, and IV in 8. Eight total and 36 subtotal R0 gastrectomies were performed (12 D(1) and 32 D(2)). The mean number of dissected lymph nodes was 38.1 +/- 21.5. Conversion rate was 7%. Operative mortality and morbidity were 7% and 12%, respectively. Three-year survival was 75%.

Conclusions: Laparoscopic radical total or subtotal gastrectomy with extended lymphadenectomy for gastric cancer is a feasible, safe, and oncologically effective procedure.