Open versus laparoscopy-assisted D2 radical gastrectomy in advanced upper gastric cancer: a retrospective cohort study.

BACKGROUND/AIMS: We conducted this study to compare open versus laparoscopy-assisted D2 radical gastrectomy in advanced upper gastric cancer.

METHODOLOGY

We reviewed 84 advanced gastric cancer patients who had pancreas-and-spleen preserving D2 lymph node dissection between March 2008 and March 2012. A comparative study was made about the short-term and long-term effect between laparoscopy-assisted D2 radical gastrectomy (LAG) on 41 patients and open D2 radical gastrectomy (OG) on 43 patients.

RESULTS

The clinical characteristics of patients in the two groups were well matched. Operative findings, postoperative recovery, morbidity, pathological findings in the two groups were also similar. The mean operating time was significantly longer for the LAG group (p=0.001); The Estimated blood loss reduced significantly in the LAG group (p=0.010). The mean number of days when body temperature exceeded 37°C and number of days to get out of bed were significantly shorter in the LAG group (p=0.001 and p=0.014 respectively). There were no postoperative deaths in both groups. The postoperative morbidity rate was 14.63% in the LAG group and 23.26% in the OG group with no significant difference (p=0.314). The overall survival rates were 58.5% and 60.5% in the LAG and OG groups, respectively. The estimated mean survival time is 35.768 months in the LAG group and 38.664 months in the OG group, respectively. There was no statistically significant difference in the overall survival rate for patients in both groups.

CONCLUSION

As for the advanced gastric cancer patient who is suitable for pancreas-and-spleen preserving D2 radical gastrectomy, LAG is a safe and feasible procedure with adequate lymphadenectomy, good curability and survival rate.