Comparison of laparoscopic versus open gastrectomy for gastric cancer. (December 2020)

• Record Type: Journal Article
• Authors: Li, Bofei; Yu-Hong Wong, Ian; Siu-Yin Chan, Fion; Chan, Kwan Kit; Lai-Yin Wong, Claudia; Law, Tsz-Ting; Yat-Yin Kwok, Jeanette; Law, Simon
• Is Part Of: Surgical oncology. Volume 35(2020)
• Page Start: 14
• Page End: 21
• Publication Date: 2020-12
• Subjects: Laparoscopic gastrectomy -- Open gastrectomy -- Gastric cancer; Cancer -- Surgery -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Electronic journals; 616.994059
• DOI: 10.1016/j.suronc.2020.06.008
• Languages: English
• ISSNs: 0960-7404

Abstract

Abstract: Background: This study aimed to compare the short-term and long-term outcomes of laparoscopic gastrectomy (LG) and open gastrectomy (OG) for gastric cancer in a tertiary referral center in Hong Kong. Methods: Two hundred and ninety-four consecutive patients with gastric cancer who underwent radical gastrectomy with curative intent between January 2008 and December 2015 were analyzed. Data was prospectively collected and reviewed. Propensity score matching was applied at a ratio of 1:1 to compare the OG and LG groups. Results: After propensity score matching, operation duration (294.7 vs 231.8min, P < 0.01) was significantly longer while estimated blood loss (191.6 vs 351.0 ml, P = 0.01) was significantly less in LG group compared with OG. There were no significant differences in postoperative complications and mortality between LG and OG groups (postoperative complication rate, 35.2% vs 40.7%, P = 0.69; 90-day mortality rate, 1.9% vs 3.7%, P = 1.00). Three-year OS and 3-yr DFS of patients who underwent LG was not inferior to that of patients who had OG (P = 0.34; P = 0.51). However, there were significantly more peritoneal recurrences among the OG group than LG group (P < 0.01). Conclusions: LG has comparable outcomes for gastric cancer, even in advanced tumors. We could appropriately increase the proportion of laparoscopic gastrectomy for gastric cancer. Highlights: This is the first report on this issue from Hong Kong. Higher peritoneal recurrence rate was observed after OG than LG. More liberal use of LG can be advocated outside high volume centers.