Laparoscopic versus open subtotal gastrectomy for adenocarcinoma: a case-control study

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Laparoscopic gastrectomy for gastric adenocarcinoma is an emerging technique in Western medicine.
• Large-scale studies are needed to validate its benefits.

Purpose of the Study:

• To compare the technical feasibility and oncologic efficacy of totally laparoscopic versus open subtotal gastrectomy for gastric adenocarcinoma.
• To evaluate patient outcomes and complications between the two surgical approaches.

Main Methods:

• A case-controlled study using a prospective gastric cancer database.
• Thirty laparoscopic subtotal gastrectomy patients were matched with 30 open subtotal gastrectomy patients.
• Comparison included demographics, TNM stage, histology, tumor location, lymph node retrieval, recurrence, margins, and complications.

Main Results:

• Laparoscopic surgery had longer operative times but resulted in significantly shorter hospital stays and reduced postoperative pain.
• Oncologic outcomes, including margin status and lymph node retrieval, were similar between groups.
• The laparoscopic approach showed a trend towards fewer early complications and significantly fewer late complications compared to open surgery.

Conclusions:

• Laparoscopic subtotal gastrectomy is technically feasible and oncologically equivalent to open surgery for gastric adenocarcinoma.
• It offers advantages such as reduced hospital stay, decreased pain, and fewer complications, making it preferable for selected patients.