Outcome of laparoscopic total gastrectomy for gastric carcinoma

Minimally invasive gastrectomy for gastric carcinoma is gaining widespread acceptance. However, data are still lacking on the feasibility, long- and short-term outcomes of laparoscopic total gastrectomy. The purpose of the study was to evaluate the feasibility, safety and long-term results of laparoscopic total gastrectomy.

Between January 2008 and January 2013, 74 patients with gastric carcinoma who had been subjected to laparoscopic total gastrectomy were evaluated. Each patient was matched to one patient undergoing open total gastrectomy for age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) grade and clinical TNM stage. Surgical and long-term survival outcomes were evaluated.

No differences in baseline data, pathological data and incidence of postoperative 30-day complications were found between the two groups. The blood loss and postoperative hospital stay for the laparoscopy group was significantly shorter than for the open group. In long-term results, no difference was found in overall survival rate (p=0.257) and disease-free survival rate (=0.207) between the two groups. When patients were analyzed according to the pathological TNM stage, the 5-year overall survival rates and disease-free survival rates were not different.

Laparoscopic total gastrectomy for gastric carcinoma is feasible and results in comparable oncologic outcomes as in open total gastrectomy.