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Laparoscopic versus open total gastrectomy for advanced proximal gastric carcinoma: a matched pair analysis
Yi Lu1, Baocheng Jiang, Tao Liu
1Department of General Surgery, Suzhou Kowloon Hospital, Suzhou, People's Republic of China.
Purpose:
Laparoscopic total gastrectomy for advanced proximal gastric carcinoma is a complex and challenging procedure, limited to a few expert centers. This study analyzed the short- and long-term outcomes of laparoscopic total gastrectomy for advanced proximal gastric carcinoma compared with open gastrectomy.
Methods:
From January 2008 to January 2015, 61 patients underwent laparoscopic total gastrectomy for advanced proximal gastric carcinoma. They were matched and compared to 61 patients who underwent a conventional open operation. Short-term operative and postoperative outcomes as well as long-term outcomes, including overall survival and disease-free survival rates, were assessed.
Results:
Patients were well matched for several preoperative factors. Overall postoperative 30-day complication rates were significantly higher for the open group. No significant difference was seen in 5-year overall survival and 5-year disease-free survival between the open and laparoscopic groups. The same result was seen in subgroup analyses of TNM stage.
Conclusion:
This study shows the feasibility of laparoscopic total gastrectomy for advanced proximal gastric carcinoma compared to open resection in regard to both short- and long-term outcomes. Laparoscopic surgery offers many advantages commonly attributed to laparoscopy and is well suited for proximal gastric carcinoma when performed by experienced surgeons.
