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Laparoscopic Radical Gastrectomy for Remnant Gastric Cancer
Published on: October 31, 2025
Laparoscopic subtotal gastrectomy for gastric cancer
Danny Rosin1, Yuri Goldes, Barak Bar Zakai
1The Department of General Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Israel. drosin@mac.com
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|October 2, 2009
Summary
Laparoscopic subtotal gastrectomy for distal gastric cancer shows promising oncologic outcomes, with a 5-year survival rate of 79%. This minimally invasive approach may be considered for selected patients, pending further research.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Laparoscopic surgery for gastric malignancy remains controversial.
- Evidence suggests potential safety and applicability of laparoscopic approaches.
- This study reviews experience with laparoscopic gastrectomy for gastric tumors requiring subtotal resection.
Purpose of the Study:
- To review institutional experience with laparoscopic subtotal gastrectomy.
- To assess the oncologic outcomes of this minimally invasive procedure.
- To evaluate the safety and efficacy in treating gastric malignant tumors.
Main Methods:
- Laparoscopic subtotal gastrectomy (D1 with Billroth-2 reconstruction) performed based on surgeon and patient preference.
- Prospective data collection on demographics, operative details, and postoperative course.
- Survival data obtained from national census, with a mean follow-up of 39 months.
Main Results:
- Twenty patients (10 male, 10 female, mean age 67) underwent the procedure for adenocarcinoma, lymphoma, or GIST.
- Mean operative time was 335 minutes; all achieved tumor-free margins with retrieval of 15 lymph nodes.
- Median hospital stay was 12 days; 4 patients required re-operation due to complications. No perioperative mortality. 5-year survival was 79%, with nodal involvement predicting poorer outcomes.
Conclusions:
- Laparoscopic subtotal gastrectomy, though complex, offers acceptable surgical and oncologic results.
- Outcomes may improve with increased surgeon experience.
- The approach is a potential option for distal gastric malignancy, but more data are needed for widespread recommendation.
