[Comparison of early clinical outcomes between laparoscopic total gastrectomy and open total gastrectomy for early-stage gastric cancer].
OBJECTIVE
Recently, laparoscopic distal gastrectomy has become one of the standard therapies for early gastric cancer. However, there are still some obstacles in performing laparoscopic total gastrectomy (LTG) as a standard therapy due to the difficulties in surgical techniques. We have performed LTG for patients with early gastric cancer in the upper portion of the stomach since 2010. In this study, we compared early clinical outcomes of LTG with those of open total gastrectomy (OTG) for patients with cT1N0 gastric cancer.


METHODS
We reviewed 69 patients who had gastric cancer of cStage IA between January 2010 and December 2013. We performed a comparative study of short-term clinical outcomes, quantity of dissected lymph nodes, and in-hospital costs between patients undergoing LTG (n=34) and those undergoing OTG (n=35).


RESULTS
The clinical characteristics of patients were well matched in the LTG and OTG groups. The median operating time was significantly longer for the LTG group (p<.0001). The estimated blood loss was significantly reduced in the LTG group (p< 0.0001). The postoperative morbidity rate was 14.7% in the LTG group and 14.2% in the OTG group with no significant difference. There were no differences in the total cost for hospital stay between the LTG and OTG groups.


CONCLUSIONS
We were able to perform LTG safely and successfully for early gastric cancer in our institute. The total cost of the treatment was almost the same between LTG and OTG. We conclude that LTG is a potential alternative in the management of early gastric cancer.
Dept. of Gastrointestinal Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases.
Takeo
T
Hara
Yoshiyuki
Y
Fujiwara
Keijiro
K
Sugimura
Kentaro
K
Kishi
Masaaki
M
Motoori
Norikatsu
N
Miyoshi
Hirofumi
H
Akita
Kunihito
K
Gotoh
Hidenori
H
Takahashi
Shigeru
S
Marubashi
Shingo
S
Noura
Masayuki
M
Ohue
Masato
M
Sakon
Masahiko
M
Yano
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000191:economics / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome