The role of laparoscopic surgery in the treatment of gastric cancer has not yet been defined, and many doubts remain about the ability to satisfy all the oncologic criteria met during conventional, open surgery.
Dr Ponzano and colleagues undertook a study in order to compare technical feasibility and both early and 5-year clinical outcomes of laparoscopic-assisted and open radical subtotal gastrectomy for distal gastric cancer.
The researchers reviewed a total of 59 patients in a prospective, randomized clinical trial.
The research team randomly assigned 29 (49.1%) patients to undergo open subtotal gastrectomy (OG) and 30 (50.9%) patients to the laparoscopic group (LG).
| Mean number of resected lymph nodes was 33.4 +/- 17.4 in the OG group and 30.0 +/- 14.9 in the laparoscopic group|
|Annals of Surgery|
The researchers studied demographics, histologic type of the tumor, number of resected lymph nodes, postoperative complications, and 5-year overall and disease-free survival rates in order to assess outcome differences between the groups.
The demographics, preoperative data, and characteristics of the tumor were similar.
The research team found that the mean number of resected lymph nodes was 33.4 +/- 17.4 in the OG group and 30.0 +/- 14.9 in the LG.
In addition, the researchers found that operative mortality rates were 6.7% (2 patients) in the OG and 3.3% (1 patient) in the LG; morbidity rates were 27.6% and 26.7%, respectively.
The researchers noted that 5-year overall and disease-free survival rates were 55.7% and 54.8% and 58.9% and 57.3% in the OG and the LG, respectively.
Dr Ponzano concluded, "Laparoscopic radical subtotal gastrectomy for distal gastric cancer is a feasible and safe oncologic procedure with short- and long-term results similar to those obtained with an open approach."
"Additional benefits for the laparoscopic group were reduced blood loss, shorter time to resumption of oral intake, and earlier discharge from hospital."