Charleen Yeo, Enming Yong, Danson Yeo, Kaushal Sanghvi, Aaryan Koura, Jaideepraj Rao, Myint Oo Aung. Tan Tock Seng Hospital
Introduction: Gastric cancer is one of the most common cancers in the Asian population, with recent literature supporting the laparoscopic approach in early disease. However, the minimally invasive approach in advanced disease is still controversial. The outcomes of laparoscopic gastrectomy in the elderly have also not been extensively studied. We aim to evaluate our institution’s short term outcomes of laparoscopic versus open gastrectomy for gastric cancer – with particular focus on advanced disease and elderly patients.
Methodology: We prospectively collected the data of all patients who underwent gastrectomies for stomach cancer from 2008 to 2015. All patients underwent a partial or total gastrectomy with D2 lymphadenectomy. The decision for open or laparoscopic approach was decided between surgeon and patient. We excluded patients who underwent palliative resection. All patients were followed up for at least one year post-operatively.
Results: There were 164 patients, with 58 open and 106 laparoscopic gastrectomies. There were 9 conversions to open surgery. We stratified our patient population according to age, with 46 (28%) patients younger than 65 years, 50 (30%) patients between 65-74 years, and 68 (41%) patients aged 75 and older. There was no difference in the proportion of patients undergoing laparoscopic versus open gastrectomy when compared across age groups. The laparoscopic group had a significantly longer operative time (268 vs 223 min, p<0.001), with a non-significant trend towards less blood loss (287 vs 330mls) and shorter length of stay (10 vs 13 days).There was no difference between number of lymph nodes harvested, 30-day morbidity and mortality. When stratified according to age and stage, survival curve analysis performed for laparoscopic versus open gastrectomy showed no difference between disease free or overall survival.
Conclusion: The short term outcomes of laparoscopic gastrectomy are comparable to that of open surgery in our institution, even in the elderly patient population with advanced disease. Our experience suggests that laparoscopic gastrectomy for gastric cancer is safe and feasible in experienced hands.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87916
Program Number: P473
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster