Laparoscopy-assisted D2 radical distal gastrectomy for advanced gastric cancer: initial experience

Laparoscopy-assisted radical gastrectomy is gaining acceptance for treating early gastric cancer. However, few reports concerning the effectiveness of laparoscopy-assisted D2 radical distal gastrectomy (LADG) for advanced gastric cancer or data comparing the results obtained after open distal gastrectomy (ODG) are yet available. The aim of this study was to evaluate the method, feasibility and clinical result of LADG for advanced gastric cancer.

A retrospective study was performed comparing LADG and ODG for advanced gastric cancer. Seventy-eight patients who underwent LADG were compared with 90 patients who underwent ODG in terms of pathologic findings, operative outcome, and complications.

There was no conversion to open surgery in the LADG group and no postoperative mortality of any patients. There were no significant differences between LADG and ODG in operative time ((245 +/- 35) vs (220 +/- 20) minutes), complication rate (7.7% vs 10.0%), and number of lymph nodes (23.5 +/- 6.0 vs 21.0 +/- 7.5), while the blood loss was less after LADG ((110 +/- 25) vs (196 +/- 30) ml, P < 0.05). The time to postoperative flatus and postoperative hospital stay were shorter after LADG ((73.0 +/- 8.5) vs (102.0 +/- 10.5) hours, and (8.6 +/- 1.2) vs (12.1 +/- 2.5) days, P < 0.05, respectively).

LADG for advanced gastric cancer is feasible, safe, and minimally invasive.