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Laparoscopic Versus Open Gastrectomy for Gastric Adenocarcinoma in the West: A Case–Control Study

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Introduction

Data on laparoscopic gastrectomy in patients with gastric cancer in the Western hemisphere are lacking. This study aimed to compare outcomes following laparoscopic versus open gastrectomy for gastric adenocarcinoma at a Western center.

Methods

Eighty-seven consecutive patients who underwent laparoscopic gastrectomy from November 2005 to April 2013 were compared with 87 patients undergoing open resection during the same time period. Patients were matched for age, stage, body mass index, and procedure (distal subtotal vs. total gastrectomy). Endpoints were short- and long-term perioperative outcomes.

Results

Overall, 65 patients (37 %) had locally advanced disease, and 40 (23 %) had proximal tumors. The laparoscopic approach was associated with longer operative time (median 240 vs.165 min; p < 0.01), less blood loss (100 vs.150 mL; p < 0.01), higher rate of microscopic margin positivity (9 vs.1 %; p = 0.04), decreased duration of narcotic and epidural use (2 vs. 4 days, p = 0.04, and 3 vs. 4 days, p = 0.02, respectively), decreased minor complications in the early (27 vs. 16 %) and late (17 vs. 7 %) postoperative periods (p < 0.01), decreased length of stay (5 vs. 7 days; p = 0.01), and increased likelihood of receiving adjuvant therapy (82 vs. 51 %; p < 0.01). There was no difference in the number of lymph nodes retrieved (median 20 in both groups), major morbidity, or 30-day mortality.

Conclusions

Laparoscopic gastrectomy for gastric adenocarcinoma is safe and effective for select patients in the West.

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Authors and Affiliations

  1. Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Kaitlyn J. Kelly MD, Luke Selby MD, Katerina Dukleska MD, Daniel G. Coit MD, Murray F. Brennan MD & Vivian E. Strong MD

  2. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Joanne F. Chou MPH & Marinela Capanu PhD

Authors
  1. Kaitlyn J. Kelly MD
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  2. Luke Selby MD
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  3. Joanne F. Chou MPH
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  4. Katerina Dukleska MD
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  5. Marinela Capanu PhD
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  6. Daniel G. Coit MD
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  7. Murray F. Brennan MD
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  8. Vivian E. Strong MD
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Corresponding author

Correspondence to Vivian E. Strong MD.

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Kelly, K.J., Selby, L., Chou, J.F. et al. Laparoscopic Versus Open Gastrectomy for Gastric Adenocarcinoma in the West: A Case–Control Study. Ann Surg Oncol 22, 3590–3596 (2015). https://doi.org/10.1245/s10434-015-4381-y

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  • DOI: https://doi.org/10.1245/s10434-015-4381-y

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