[Laparoscopic total gastrectomy].

Aim: Laparoscopic total gastrectomy for cancer have been rarely adopted in Czech Republic. The aim of this study is to assess results of these procedures analyzing our series of patients.

Material And Methods: From May 2002 to June 2010 43 laparoscopic total gastrectomies with lymphadenectomy were performed for patients with gastric cancer. Clinical and tumor parameters, perioperative characteristics, short term and long term results were analyzed retrospectively.

Results: Males were 27 (63%) and females were 16 (37%). Mean age was 65 years (range 48-80), mean BMI was 25.7 (range 18.7-37.0). 27 patients (63%) had an ASA score III and 16 patients (37%) had an ASA score II. The patologic stage (UICC) was 10 stage I (23%), 10 stage II (23%), 19 stage III (44%) and 4 stage IV (9%). The mean operation time was 292 minutes (range 180-400). Conversion was necessary in four cases (9%) and hand assisted technique was used in four cases (9%). The number of retrieved lymph node were 18 (range 4-32). Five laparoscopic total gastrectomies were estimated as palliative. Median time of hospitalization was 12 days (range 7-86). Overall morbidity was 37%, 5 patients (12%) were died related with postoperative complications. The 3-years overall survival was 50% and 5-years overall survival was 45%.

Conclusion: Laparoscopic total gastrectomy is feasible and acceptable clinically and oncologically. Surgical skill and patient's selection are necessary.