Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 7, 2011; 17(41): 4602-4606
Published online Nov 7, 2011. doi: 10.3748/wjg.v17.i41.4602
Comparative study of laparoscopic vs open gastrectomy in gastric cancer management
Giuseppe S Sica, Edoardo Iaculli, Livia Biancone, Sara Di Carlo, Rosa Scaramuzzo, Cristina Fiorani, Paolo Gentileschi, Achille L Gaspari
Giuseppe S Sica, Edoardo Iaculli, Sara Di Carlo, Rosa Scaramuzzo, Cristina Fiorani, Paolo Gentileschi, Achille L Gaspari, Department of Surgical Sciences, “Tor Vergata” University Hospital, 00133 Rome, Italy
Livia Biancone, Department of Internal Medicine, Gastrointestinal Unit, “Tor Vergata” University Hospital, 00133 Rome, Italy
Author contributions: Sica GS and Iaculli E designed and wrote the paper; Iaculli E and Scaramuzzo R did the statistical analysis; Scaramuzzo R, Fiorani C, Di Carlo S and Gentileschi P performed database and analysis of the results; Biancone L and Gaspari AL reviewed the paper and edited it.
Correspondence to: Dr. Giuseppe S Sica, MD, PhD, Department of Surgical Sciences, “Tor Vergata” University Hospital, Viale Oxford 81, 00133 Rome, Italy. sica.giuseppe@fastwebnet.it
Telephone: +39-06-20902928 Fax: +39-06-20902926
Received: December 1, 2010
Revised: January 5, 2011
Accepted: January 12, 2011
Published online: November 7, 2011
Abstract

AIM: To compare long-term results of gastric cancer patients undergoing laparoscopic and open gastrectomy in a single unit.

METHODS: From February 2000 to September 2004, all patients with adenocarcinoma of the stomach were assessed to entry in this longitudinal prospective non-randomized trial. Primary endpoint was cancer-related survival and secondary endpoints were overall survival, evaluation of surgical complications and mortality.

RESULTS: Fifty-eight patients were enrolled. Forty-seven patients were followed-up (range 11-103, median 38 mo). Four patients were lost at follow up. Twenty-two patients underwent a laparoscopic gastric surgery (LGS) and 25 had a standard open procedure (OGS). No statistical difference was found between the two groups in terms of 5 years cancer-related mortality rate (50% vs 52%, P = 1), and 5 years overall mortality rate (54.5% vs 56%, P = 1). Accordingly, cancer-related and overall survival probability by Kaplan-Meier method showed comparable results (P = 0.81 and P = 0.83, respectively). We found no differences in surgical complications in the 2 groups. There was no conversion to open surgery in this series.

CONCLUSION: LGS is as effective as OGS in the management of advanced gastric cancer. However LGS cannot be recommended routinely over OGS for the treatment of advanced gastric cancer.

Keywords: Advanced gastric cancer; Laparoscopy; Laparoscopic cancer surgery; Long-term outcomes; Survival