Laparoscopic gastrectomy for gastric cancer with simultaneous organ resection

Simultaneous organ resection is performed in 10% of laparoscopic gastrectomies for gastric cancer. The purpose of this study is to investigate the feasibility and safety of simultaneous organ resection with laparoscopic gastrectomy for gastric cancer.

We retrospectively reviewed the medical records from a prospectively collected database of patients who underwent laparoscopic gastrectomy from May 2003 to April 2012 in a single center. The patients were classified into three groups: a gastrectomy-only (no simultaneous resection [NS]) group as a control, a combined resection (CB) group characterized by additional resection due to tumor invasion and extensive lymphadenectomy, and a concomitant resection (CC) group, including patients with other pathologic conditions. The clinical outcomes, in particular morbidity and mortality, were compared among the three groups.

The NS, CB, and CC groups included 1883 (90.1%), 66 (3.2%), and 140 (6.7%) patients, respectively. Mean operation time was longer in CB and CC patients than in NS patients (233.0 ± 59.3, 227.4 ± 100.9, and 180.1 ± 54.0 minutes, respectively; P<.001), and mean hospital stay was longer in the CB and CC groups than in the NS group (9.6 ± 5.2, 8.3 ± 4.7, and 6.9 ± 4.4 days, respectively; P<.001). However, there were no statistically significant differences among the groups in the incidence of complications (P=.185), complications more severe than grade II (P=.077), and mortality (P=1.000).

Laparoscopic simultaneous organ resection during laparoscopic gastrectomy for gastric cancer prolonged the operation time and hospital stay but did not increase morbidity and mortality.