AI Article Synopsis
- There is a lack of data on laparoscopic gastrectomy for gastric cancer in the Western hemisphere, prompting a study to compare its outcomes with open gastrectomy.
- This study involved 87 patients who underwent laparoscopic surgery and 87 who had open surgery, with careful matching based on factors like age and disease stage to assess various outcomes.
- Results showed that while laparoscopic procedures took longer, they were linked to less blood loss, shorter hospital stays, fewer complications, and a higher likelihood of patients receiving follow-up therapy, indicating that this approach is safe and effective for certain patients.
Article Abstract
Introduction: Data on laparoscopic gastrectomy in patients with gastric cancer in the Western hemisphere are lacking. This study aimed to compare outcomes following laparoscopic versus open gastrectomy for gastric adenocarcinoma at a Western center.
Methods: Eighty-seven consecutive patients who underwent laparoscopic gastrectomy from November 2005 to April 2013 were compared with 87 patients undergoing open resection during the same time period. Patients were matched for age, stage, body mass index, and procedure (distal subtotal vs. total gastrectomy). Endpoints were short- and long-term perioperative outcomes.
Results: Overall, 65 patients (37 %) had locally advanced disease, and 40 (23 %) had proximal tumors. The laparoscopic approach was associated with longer operative time (median 240 vs.165 min; p < 0.01), less blood loss (100 vs.150 mL; p < 0.01), higher rate of microscopic margin positivity (9 vs.1 %; p = 0.04), decreased duration of narcotic and epidural use (2 vs. 4 days, p = 0.04, and 3 vs. 4 days, p = 0.02, respectively), decreased minor complications in the early (27 vs. 16 %) and late (17 vs. 7 %) postoperative periods (p < 0.01), decreased length of stay (5 vs. 7 days; p = 0.01), and increased likelihood of receiving adjuvant therapy (82 vs. 51 %; p < 0.01). There was no difference in the number of lymph nodes retrieved (median 20 in both groups), major morbidity, or 30-day mortality.
Conclusions: Laparoscopic gastrectomy for gastric adenocarcinoma is safe and effective for select patients in the West.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5050554 | PMC |
| http://dx.doi.org/10.1245/s10434-015-4381-y | DOI Listing |
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