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Intraoperative Gastroscopy for Tumor Localization in Laparoscopic Surgery for Gastric Adenocarcinoma
Published on: August 9, 2016
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Subtotal versus total gastrectomy for distal diffuse-type gastric cancer
Jorge A Gajardo1,2, Francisco J Arriagada3, Florencia D Muñoz3
1Upper Gastrointestinal Surgery Unit, Hospital Guillermo Grant Benavente, Concepción, Chile. drjorgegajardo@gmail.com.
Surgical Endoscopy
|September 23, 2024
Summary
For diffuse-type gastric cancer, subtotal gastrectomy offers similar survival outcomes to total gastrectomy. This suggests subtotal gastrectomy is an adequate surgical option for distal gastric cancer when feasible.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Diffuse-type gastric carcinoma is an aggressive cancer.
- Surgical resection is the primary curative treatment.
- The choice between total and subtotal gastrectomy for distal tumors remains debated.
Purpose of the Study:
- To compare oncologic outcomes and overall survival.
- To evaluate subtotal versus total gastrectomy for distal diffuse-type gastric cancer.
- To determine the adequacy of subtotal gastrectomy when feasible.
Main Methods:
- Retrospective study of 130 patients with distal diffuse-type gastric carcinoma (cT1-4M0).
- Comparison of subtotal gastrectomy (STG) versus total gastrectomy (TG) groups.
- Data analyzed for sociodemographic, pathological, and perioperative variables.
Main Results:
- All patients achieved R0 resection.
- No significant differences in lymph node yield, tumor size, or invasion depth.
- Similar overall survival rates between STG and TG groups (5-year OS: 63% vs. 51%, p=0.097).
Conclusions:
- Subtotal gastrectomy with D2-lymphadenectomy is oncologically equivalent to total gastrectomy for distal diffuse-type gastric cancer.
- Subtotal gastrectomy does not decrease median overall survival.
- Subtotal gastrectomy is an adequate surgical approach when technically feasible.
