Yoontaek Lee, MD, Sa-Hong Min, MD, Young Suk Park, MD, Sang-Hoon Ahn, MD, Do Joong Park, MD, PhD. Seoul National University Bundang Hospital
Purpose: This study summarizes the single institution experience of laparoscopic gastrectomy in advanced gastric cancer and evaluates the postoperative morbidities and long-term oncologic outcomes.
Methods: A total of 1,597 laparoscopic gastrectomy for advanced gastric cancer were performed at Seoul National University Bundang Hospital between May 2003 and May 2017. The characteristics of patients, surgical techniques, postoperative morbidities, and long-term oncologic outcomes were retrospectively reviewed using electronic medical records.
Results: 109 patients required conversion to open surgery. The reasons of conversion to open surgery were advanced stage(n=59), intraoperative bleeding(n=19), adhesion due to previous abdominal operation(n=10), small abdominal cavity(n=4), associated disease(n=4), and intraoperative pleural injury(n=2). The mean hospital stay was 7.0 days for distal gastrectomy, 9.6 days for total gastrectomy, 8.3 days for proximal gastrectomy, and 6.5 days for pylorus preserving gastrectomy. The mean number of collected lymph nodes was 58.7 for distal gastrectomy, 70.1 for total gastrectomy, 43.0 for proximal gastrectomy, and 46.5 for pylorus preserving gastrectomy. The rates of postoperative complications of grade II or more were 9.4 %. There was one case of postoperative mortality due to delayed bleeding after discharge. Old age was the only independent predictor of surgical morbidities. The 5-year overall survival rates were 90.8% in stage IB, 89.7% in stage IIA, 83.1% in stage IIB, 81.1% in stage IIIA, 67.1% in stage IIIB, 57.9% in stage IIIC, and 35.8% in stage IV. The 3-year disease free survival rates were 97.2% in stage IB, 94.1% in stage IIA, 87.2% in stage IIB, 77.5% in stage IIIA, 74.6% in stage IIIB, and 47.8% in stage IIIC. Histologic type, vascular invasion, tumor size, and TNM stage were factors associated with disease free survival rates in the multivariate analysis.
Conclusion: Laparoscopic gastrectomy was safe and technically feasible for the treatment of advanced gastric cancer, with acceptable rate of morbidity and mortality.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86936
Program Number: P437
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster