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05.11.2015 | Ausgabe 8/2016

Surgical Endoscopy 8/2016

Total laparoscopic resection for advanced gastric cancer is safe and feasible in the Western population

Zeitschrift:
Surgical Endoscopy > Ausgabe 8/2016
Autoren:
Rebecca Tuttle, Steven N. Hochwald, Moshim Kukar, Kfir Ben-David

Abstract

Background

There is debate surrounding the use of laparoscopic resection for advanced gastric cancer in the Western population. Here we aim to assess the feasibility and short-term outcomes of laparoscopic gastrectomy in consecutive patients in a Western population.

Methods

From 2012 to 2014, retrospective review of 28 patients with clinically staged advanced gastric cancer (≥T3 or ≥N1) treated with laparoscopic resection.

Results

Sixty-one percentage of patients were male. Median age was 67 years (range 35–86). Median BMI was 26.5 (range 19.4–46.1). Resection types were proximal (n = 2), distal (n = 14), and total (n = 12). Twenty-six (93 %) patients underwent D2 lymphadenectomy. Four patients underwent conversion to open. Median blood loss was 125 mL (range 30–300). Median LOS was 7 days (range 4–16). Of postoperative complications, five were minor: arrhythmia (n = 1), surgical site infection (n = 3), in-hospital fall (n = 1); and four were major (intra-abdominal abscess, stricture, PE, and anastomotic bleed). T stages were Tx (n = 1), T2 (n = 3), T3 (n = 18), and T4 (n = 6). N stages were N0 (n = 4), N1 (n = 8), N2 (n = 1), and N3 (n = 15). Median tumor size was 5.8 cm (range 0–9.5). Median lymph node yield was 22 (range 6–53). All margins were negative. Median follow-up was 12.8 months (range 2–27). Six patients have died of progressive disease.

Conclusion

Following total laparoscopic resection for advanced gastric cancer, oncologic endpoints, postoperative course, and early cancer-specific follow-up are excellent. The results demonstrated here support the routine use of these techniques in the Western patient population.

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