Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer: early and long-term results of a 100-patient series.
BACKGROUND
Controversies exist about feasibility and oncologic effectiveness of laparoscopic gastrectomies with extended lymphadenectomy for advanced gastric cancer. The aim of our study was to determine if long-term results of these laparoscopic procedures may justify their use as an alternative to open surgery also in advanced gastric cancer.


METHODS
We performed a retrospective review of 100 patients after laparoscopic surgery for gastric cancer.


RESULTS
Tumor stage (S) was SIA in 21 patients, SIB in 20, SII in 17, SIIIA in 17, SIIIB in 5, and SIV in 20. Eleven total and 89 subtotal R0 gastrectomies were performed. The mean number of dissected lymph nodes was 35 +/- 18. The conversion rate was 3%. Surgical mortality and major morbidity were 6% and 13%, respectively. Overall and disease-free 5-year survival rates were 59% and 57%, respectively.


CONCLUSIONS
Laparoscopic gastrectomy with extended lymphadenectomy for early and advanced gastric cancer is feasible, safe, and oncologically effective. Long-term survival rates are similar to those observed after open surgery.
Huscher
Cristiano G S
CG
Department of Health Sciences, Division of Surgery, Veneziale Hospital, Molise University, Isernia, Italy.
Mingoli
Andrea
A
Sgarzini
Giovanna
G
Brachini
Gioia
G
Binda
Barbara
B
Di Paola
Massimiliano
M
Ponzano
Cecilia
C
D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome