Laparoscopic versus open gastrectomy for gastric adenocarcinoma in the West: A case-control study Journal Article
| Authors: | Kelly, K. J.; Selby, L.; Chou, J. F.; Dukleska, K.; Capanu, M.; Coit, D. G.; Brennan, M. F.; Strong, V. E. |
| Article Title: | Laparoscopic versus open gastrectomy for gastric adenocarcinoma in the West: A case-control study |
| 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. © 2015, Society of Surgical Oncology. |
| Keywords: | adult; aged; cancer surgery; major clinical study; case control study; mortality; postoperative period; advanced cancer; diarrhea; gastrointestinal hemorrhage; cancer adjuvant therapy; cancer patient; outcome assessment; follow up; laparoscopic surgery; infection; anemia; dehydration; morbidity; deep vein thrombosis; fever; lung embolism; acute kidney failure; length of stay; body mass; heart infarction; lymph node; pancreatitis; operation duration; urinary tract infection; gastrectomy; intermethod comparison; atelectasis; pleura effusion; perioperative period; heart arrhythmia; malnutrition; postoperative hemorrhage; stomach adenocarcinoma; personal experience; hematoma; ileus; postoperative pain; small intestine obstruction; anastomotic stricture; laparoscopic gastrectomy; anastomosis leakage; pancreas fistula; incisional hernia; stomach emptying; anastomosis dehiscence; internal hernia; human; male; female; article; duodenal stump leak; open gastrectomy; seep space infection; superficial site infection |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 22 |
| Issue: | 11 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2015-10-01 |
| Start Page: | 3590 |
| End Page: | 3596 |
| Language: | English |
| DOI: | 10.1245/s10434-015-4381-y |
| PROVIDER: | scopus |
| PUBMED: | 25631063 |
| PMCID: | PMC5050554 |
| DOI/URL: | |
| Notes: | Export Date: 2 October 2015 -- Source: Scopus |
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