Comparison of laparoscopic and open gastrectomy for malignant disease.
This study compares the outcome of a series of totally laparoscopic cases with that of matched open controls for the treatment of malignant gastric disease. Laparoscopic techniques can follow oncologic principles and obtain adequate margins. Short-term follow-up evaluation shows no difference in survival rates between the two approaches.


BACKGROUND
Few studies have examined a totally laparoscopic approach to gastrectomy for malignancy. This is the first study to compare the outcome of a series of totally laparoscopic cases with matched open surgeries for gastric cancer.


METHODS
A retrospective case-matched study was performed comparing open and laparoscopic partial gastrectomies for cancer. A total of 25 cases (12 laparoscopic and 13 open) were matched for age and indication for surgery. Stage, extent of lymphadenectomy, and survival at 18 months were examined. The intraoperative and postoperative details were compared.


RESULTS
The stages ranged from I to IV, with no statistical difference between the two groups. All resected margins in the laparoscopic group were free of tumor. The extent of lymphadenectomy did not differ. Follow-up assessment at 18 months showed no difference in survival.


CONCLUSIONS
Laparoscopic gastrectomy for malignancy is a viable alternative to open surgery. Laparoscopic techniques can obtain adequate margins and follow oncologic principles. Short-term follow-up evaluation shows no difference in survival rates between the two approaches.
Weber
K J
KJ
Department of Surgery, The Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029-6574, USA.
Reyes
C D
CD
Gagner
M
M
Divino
C M
CM
D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001810:Blood Volume; D002276:Carcinoid Tumor / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D007902:Length of Stay; D008223:Lymphoma / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D017678:Sex Distribution; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors