Vo D Long, MS, Nguyen H Bac, Prof, Nguyen V Tuan Anh, Nguyen V Hai, Ho L Minh Quoc, Tong P Quang Trung. University Medical Center
Background: Laparoscopic gastrectomy with lymphadenectomy for gastric cancer has been performed in Viet Nam as a technique that may offer benefits for patients. But the role is still controversial. The aim of this study was to evaluate technical feasibility, the safety and 5-year overall survival results of laparoscopic gastrectomy with D2 lymphadenectomy for gastric adenocarcinoma.
Methods: This was a prospective, case-series with a total of 268 patients affected gastric adenocarcinoma between July 2008 and July 2016, at University Medical Center, Hochiminh city, Vietnam. Of this 268 patients, 223 cases underwent laparosopic distal gastrectomy and 45 patients underwent laparoscopic total gastrectomy. Demographics, ASA status, pTNM stage, histological type of the tumor, tumor diameter, operative time, intraoperative blood loss, number of resected lymph nodes, postoperative complications and 1-year, 3-year and 5-year overall survival rates were studied to assess outcomes of this procedure.
Results: There were 120 women and 148 men with a mean age of 55.4 years. The D2 lymphadenectomy was performed in all patients, with the convertion rate was 0.4%. Intracorporeal anastomosis was performed in 182 patients by using stapler and extracorporeal anastomosis in 86 cases by using the hand-sewn technique. Stages of the tumor were IA in 10 (3.7%) patients, IB in 8 (3%), IIA in 50 (18.7%), IIB in 72 (26.9%), IIIA in 42 (15.7%), IIIB in 49 (18.3%), and IIIC in 37 (13.8%) patients. The mean operating time was 185 ± 32 minutes. The estimated intraoperative blood loss was 45 ± 12 ml, and no transfusion was required. The mean number of resected lymph nodes was 29.7 ± 12.1. All resected margin was negative. The overall postoperative complication rates were 7.5% (20 patients) including anastomotic leak (1 case), duodenal stump leak (2 cases) but no reoperation was required and postoperative bleeding (3 patients) and reoperation was required to controll bleeding, wound infections (9 patients) and intra-abdominal abscesses (4 patient) and intestinal obstruction (1 patient). The mean hospital length of stay was 7.7 ± 1.6 days. No mortality was observed. One-year, three-year and five-year overall survival rates were 92.8%, 86.6% and 71.3%, respectively.
Conclusions: Laparoscopic gastrectomy and D2 lymphadenectomy for gastric cancer is technical feasibility, safe technique and provided an acceptable prognosis.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77952
Program Number: S093
Presentation Session: Foregut 2
Presentation Type: Podium
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