TITLE:
Short Term Outcomes of Laparoscopic versus Open Distal Gastrectomy with D2 Lymph Nodes Dissection for Gastric Cancer: A Prospective Study
AUTHORS:
S. Abdelaziem, Tamer A. El-Bakary, Hamdy S. Abd Allah
KEYWORDS:
Cancer Stomach, Distal Gastrectomy, Laparoscopic Resection
JOURNAL NAME:
Surgical Science,
Vol.8 No.8,
August
16,
2017
ABSTRACT: Background: Laparoscopic distal gastrectomy (LDG) for gastric adenocarcinoma (GA) is gaining more acceptances worldwide. Its results are still controversial. This study aimed to assess short term outcomes of LDG and compare it to the standard open distal gastrectomy. Patients and Methods: 27 patients with GA of the distal 2/3 of the stomach were included and divided into 2 groups; Group A: 15 patients submitted to open distal gastrectomy with D2 lymph node (LN) dissection, and Group B: 12 patients submitted to LDG with D2 LN dissection. Results: The median age was 54 and 54.3 years in group A and B respectively. The median operative time was 118.7 and 210.2 minutes in group A and B respectively. The median safety margin was 6.52 and 5.7 cm in group A and B respectively while the median number of excised LN was 24.2 and 21.4 in group A and B respectively. One patient in group B had intraoperative bleeding that was controlled laparoscopically. No conversion to open surgery needed in group B. The median number of narcotic doses was 5.9 and 4.25 in group A and B respectively. The median length of hospital stay was 7.2 days in group A and 7.3 days in group B. Three patients in group A and 2 patients in group B had postoperative complications and all were treated successfully conservatively. Conclusion: LDG with D2 LN dissection is oncologically safe with short-term outcomes comparable to those of the open surgery. Gaining more surgeons’ experience is necessary to improve these results.