Laparoscopic Gastric Surgery for Neoplasia: Are we going ahead?

INTRODUCTION: In Colorectal cancer, the increasing evidence in the literature shows improved outcome following laparoscopic surgery. However, the evidence and outcome on laparoscopic gastric surgery is limited. The purpose of this study was to assess our initial experience with laparoscopic gastric surgery for malignancy.

METHODS AND PROCEDURES: Between Sept 2003 to Aug 2007 there were a total of 71 gastrectomies performed for cancer. We analyzed the patients who had laparoscopic gastric surgery for malignancy between Feb 2005 and Aug 2007 from our prospective database. The following variables were evaluated: age, sex, tumor size, location, histological type, depth of invasion, presence of lymph node metastasis, operating time, blood loss, postoperative complications, and length of stay.

RESULTS: Twenty-two patients had laparoscopic gastric resections. There were more men than women (6:5). The mean age at operation was 70yrs (Males= 73, Females=68yrs). Majority had adenocarcinomas (15/22), 4 patients had GIST, whereas the other three had persistent moderate dysplasia, massive leiomyoma and inflammatory fibrous polyp. Majority of patients with adenocarcinoma had T2 stage tumor (68%). Majority had Gastric antrum involvement (50%) and had distal gastrectomy done. There were clear resection margins in all patients and lymph node metastasis was found in only eight patients. Three patients had to be converted to open from earlier on. There were no mortalities or leaks and minor postoperative complications occurred in 5 patients (22.7%). The length of stay ranged from 5 to 26 days.

CONCLUSION(S): Our initial experience following laparoscopic gastric surgery shows that this can be performed safely without mortality and with minimal morbidity in specialist units with experience in advanced laparoscopic and oesophagogastric surgery. It seems that the laparoscopic Gastric Surgery for malignancy is the way forward.

Session: Poster

Program Number: P268

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