title: Comparison of laparoscopic total gastrectomy and laparotomic total gastrectomy for gastric cancer.
abstract: BACKGROUND
  The use of laparoscopy for the treatment of gastric cancer suffered some resistance among surgeons around the world, gaining strength in the past decade. However, its oncological safety and technical feasibility remain controversial.
  
  
  OBJECTIVE
  To describe the results from the clinical and anatomopathological point of view in the comparative evaluation between the surgical videolaparoscopic and laparotomic treatments of total gastrectomy with linphadenectomy at D2, resection R0.
  
  
  METHODS
  Retrospective analyses and comparison data from patients submitted to total gastrectomy with D2 linphadenectomy at a sole institution. The data of 111 patients showed that 64 (57,7%) have been submitted to laparotomic gastrectomy and 47 (42,3%) to gastrectomy entirely performed through videolaparoscopy. All variables related to the surgery, post-operative follow-up and anatomopathologic findings have been evaluated.
  
  
  RESULTS
  Among the studied variables, videolaparoscopy has shown a shorter surgical time and a more premature period for the introduction of oral and enteral nourishment than the open surgery. As to the amount of dissected limph nodes, there has been a significant difference towards laparotomy with p=0,014, but the average dissected limph nodes in both groups exceed 25 nodes as recommended by the JAGC. Was not found a significant difference between the studied groups as to age, ASA, type of surgery, need for blood transfusion, stage of the disease, Bormann classification, degree of differentiation, damage of the margins, further complications and death.
  
  
  CONCLUSIONS
  The total gastrectomy with D2 lymphadenectomy performed by laparoscopy presented the same benefits known of laparotomy and with the advantages already established of minimally invasive surgery. It was done with less surgical time, less time for re-introduction of the oral and enteral diets and lower hospitalization time compared to laparotomy, without increasing postoperative complications.
authors: Department of Oncological Surgery of the Upper Gastrointestinal Tract, Barretos Cancer Hospital, Rondônia, RO.
authors: Carlos Alexandre Garção
authors: CA
authors: Ramagem
authors: Department of Surgery, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil.
authors: Marcelo
authors: M
authors: Linhares
authors: Department of Oncological Surgery of the Upper Gastrointestinal Tract, Barretos Cancer Hospital, Barretos, São Paulo.
authors: Croider Franco
authors: CF
authors: Lacerda
authors: Department of Oncological Surgery of the Upper Gastrointestinal Tract, Barretos Cancer Hospital, Barretos, São Paulo.
authors: Paulo Anderson
authors: PA
authors: Bertulucci
authors: Department of Oncological Surgery of the Upper Gastrointestinal Tract, Barretos Cancer Hospital, Barretos, São Paulo.
authors: Durval
authors: D
authors: Wonrath
authors: Department of Oncological Surgery of the Upper Gastrointestinal Tract, Barretos Cancer Hospital, Barretos, São Paulo.
authors: Antônio Talvane Torres
authors: AT
authors: de Oliveira
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*