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Comparing Laparoscopic to Endoscopic Resections for Early Gastric Cancer in a High Volume North American Center

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Journal of Gastrointestinal Surgery

Abstract

Endoscopic submucosal dissection as an organ sparing option for early gastric cancer is becoming increasingly accepted as an alternative to laparoscopic gastrectomy. Given the very limited North American data, we sought to compare outcomes between endoscopic and laparoscopic resection of gastric malignant and premalignant tumors. Patients undergoing laparoscopic gastrectomy or endoscopic submucosal dissection from 2007 to 2014 for adenocarcinoma or dysplasia at the McGill University Health Center were identified from a prospectively collected database and dichotomized according to the surgical approach. Patient demographics, tumor characteristics, stage, oncologic outcome, length of stay, and postoperative complications were recorded. Of 155 patients with gastric cancer identified, 67 were treated by laparoscopic gastrectomy (n = 37) or endoscopic submucosal dissection (ESD) (n = 30). There were significantly more invasive lesions in the laparoscopic group and patients subject to ESD harbored more T1 lesions. No significant difference in the rate of R0 resection or overall complications was observed between the groups. Accordingly, length of stay was significantly shorter in the ESD group. There were no significant differences in terms of overall and disease-free survival. In selected patients, ESD is associated with improved short-term outcomes and provides an appropriate oncologic resection option in a North American patient cohort.

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Authors and Affiliations

  1. Department of Surgery, McGill University Health Center, Montreal, QC, Canada

    Sara Najmeh, Jonathan Cools-Lartigue, Carmen Mueller & Lorenzo E. Ferri

  2. Steinberg-Bernstein Center for Minimally Invasive Surgery, Montreal, QC, Canada

    Carmen Mueller & Lorenzo E. Ferri

  3. Division of Thoracic Surgery, McGill University, 1650 Cedar Ave, L9.112, Montreal, H3G 1A4, QC, Canada

    Lorenzo E. Ferri

Authors
  1. Sara Najmeh
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  2. Jonathan Cools-Lartigue
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  3. Carmen Mueller
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  4. Lorenzo E. Ferri
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Corresponding author

Correspondence to Lorenzo E. Ferri.

Ethics declarations

This study was performed in accordance with the McGill University Health Center ethics committee guidelines. Informed consent was obtained from all patients included in this study for participation.

Conflict of Interest

The authors declare that they have no conflicts of interest.

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Najmeh, S., Cools-Lartigue, J., Mueller, C. et al. Comparing Laparoscopic to Endoscopic Resections for Early Gastric Cancer in a High Volume North American Center. J Gastrointest Surg 20, 1547–1553 (2016). https://doi.org/10.1007/s11605-016-3176-1

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  • DOI: https://doi.org/10.1007/s11605-016-3176-1

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