Short-term Surgical and Long-term Survival Outcomes After Laparoscopic Distal Gastrectomy with D2 Lymphadenectomy for Gastric Cancer

Xiaowu Xu, MD, Yiping Mou, MD, FACS, Ke Chen, MS. Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University.

INTRODUCTION: This study aimed to investigate the survival outcomes of laparoscopic distal gastrectomy( LDG).

METHODS: There were 240 consecutive patients with gastric cancer who received LDG at our institution from October 2004 to April 2013. Early surgical outcomes of laparoscopy-assisted distal gastrectomy( LADG) and totally laparoscopic dital gastrectomy (TLDG) were compared and operative experiences were evaluated.

RESULTS: Of the 240 patients, 93 underwent LADG and 147 had TLDG. There were 109 T1, 36 T2, 31 T3, and 64 T4a lesions. The median follow-up period was 31.5 months (range:4-106 months). Tumors recurred in 40 patients. The 5-year disease-free survival (DFS) and overall survival (OS) rates according to the stage of tumor were 90.3% and 93.1% in stage I, 72.7% and 67.6% in stage II, and 34.8% and 41.5% in stage III, respectively. There were no signi?cant differences in early surgical outcomes such as operation time, blood loss and postoperative recovery between LADG and TLDG.

CONCLUSIONS: The ?ndings show that LDG for gastric cancer had acceptable long-term oncologic outcomes. And the early surgical outcomes of LADG and TLDG were similar.

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