title: [Totally laparoscopic gastrectomy for the treatment of gastric tumors].
abstract: BACKGROUND
  The laparoscopic approach for the treatment of gastric tumors has many advantages.
  
  
  OBJECTIVE
  To evaluate the results of a laparoscopic gastrectomy program developed in a public hospital.
  
  
  METHODS
  Retrospective review of epidemiological, perioperative and follow-up data of patients who were treated with a laparoscopic gastrectomy due to gastric tumors between 2006 and 2013. A totally laparoscopic technique was used for all cases. Complications were evaluated according to the Clavien-Dindo classification.
  
  
  RESULTS
  Fifty one patients, aged 65 (36-85) years, underwent a laparoscopic gastrectomy. In 22 patients a total gastrectomy was performed. Conversion rate to open surgery was 8%. Operative time was 330 (90-500) min and bleeding was 200 (20-500) ml. Median hospital stay was 7 (3-37) days. Postoperative morbidity was present in 17 (33%) patients, 3 (6%) patients had complications grade 3 or higher and one patient died (1.9%). Tumor pathology was adenocarcinoma in 39 patients. A complete resection was achieved in 97%. Twenty nine patients (74%) with gastric adenocarcinoma had early gastric cancer and 84% of patients were in stage one. Median lymph node count was 24. Median follow-up was 26 (1-91) months. There was no cancer related mortality among patients subjected to a curative resection. Overall survival for patients with adenocarcinoma was 92% at 3 years.
  
  
  CONCLUSIONS
  This study supports the feasibility and safety of a laparoscopic gastrectomy program in a public hospital; with low morbidity, adequate lymph node dissection and long-term survival. This approach must be considered an option for selected patients with gastric cancer.
authors.forename: Enrique
authors.initials: E
authors.lastname: Norero
authors.forename: Sergio
authors.initials: S
authors.lastname: Báez
authors.forename: Eduardo
authors.initials: E
authors.lastname: Briceño
authors.forename: Cristian
authors.initials: C
authors.lastname: Martínez
authors.forename: Marco
authors.initials: M
authors.lastname: Ceroni
authors.forename: Alex
authors.initials: A
authors.lastname: Escalona
authors.forename: Gloria
authors.initials: G
authors.lastname: Aguayo
authors.forename: Paulina
authors.initials: P
authors.lastname: González
authors.forename: Fernando
authors.initials: F
authors.lastname: Araos
authors.forename: Alfonso
authors.initials: A
authors.lastname: Calvo
authors.forename: Alfonso
authors.initials: A
authors.lastname: Díaz
authors.forename: Eduardo
authors.initials: E
authors.lastname: Viñuela
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak; D002677:Chile; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods* / Q000706:statistics & numerical data; D017219:Gastric Outlet Obstruction; D006779:Hospitals, Public; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D059035:Perioperative Period; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome