[Recent advances and some consideration about laparoscopic surgery in patients with gastric cancer]

Laparoscopy-assisted distal gastrectomy for gastric cancer was first reported in 1994. Since then, the laparoscopic approach is rapidly becoming the preferred method of treatment for patients with early gastric cancer (EGC) due to the many advantages of minimally invasive surgery. Many retrospective comparative trials and randomized-controlled trials (RCT) have confirmed that laparoscopic gastrectomy (LG) is safe and feasible, and that short-term outcomes are better than those of open gastrectomy in patients with EGC. As laparoscopic experience has accumulated, the indications for LG have been broadened to patients with advanced gastric cancer (AGC). However, the role of LG remains controversial, because studies of the long-term outcomes of LG are insufficient. Laparoscopic gastric surgery is demanding from a technical point of view, especially when a D2 lymphadenectomy is performed. Adequate training in laparoscopic techniques and procedures is mandatory prior to embarking on a LG.