Laparoscopic versus open total radical gastrectomy for advanced gastric cancer: surgical outcomes

Abstract

AIM: The aim of this study is to compare the oncologic efficacy of laparoscopic total gastrectomy (LTG) versus open total
gastrectomy (OTG) for gastric cancer and to provide our experiences regarding this surgery.
METHODS: A total of 107 patients who underwent curative total gastrectomy for gastric adenocarcinoma between September
2015 and September 2018 were included in this study. Demographic characteristics, operative parameters, histopathological results, postoperative morbidity and mortality results of the patients were evaluated.

RESULTS: Of 107 patients, 70 were men and 37 women. OTG consisted of 89 patients and LTG consisted of 18
patients. The mean age in OTG was 59.4 years, the mean age in LTG was 57.3 years. The mean number of lymph
nodes harvested was 30.5±14.6 in OTG and 33.0±10.1 in LTG. The number of metastatic lymph nodes harvested was
7.4±10.5 in OTG and 10.0±11.8 in LTG (p= 0.366), and there was no statistical difference between the two groups. The time of onset of oral intake, anastomotic leakage, and postoperative mortality was similar in both groups.
Operative duration and length of hospital stay were significantly higher in LTG. Postoperative survival duration was
similar in both procedures.

CONCLUSION: Laparoscopic total gastrectomy for gastric cancer is an oncologically safe procedure but had a longer operation time and a longer hospital stay. There was no significant difference number of harvested lymph nodes, number
of metastatic lymph nodes, and tumor localization between the two groups