Laparoscopy-assisted vs open total gastrectomy with D2 lymphadenectomy for advanced gastric cancer: results of a retrospective, multicenter study

• Published in: Updates in surgery 2023-09, Vol.75 (6), p.1645-1651
• Main Authors: Illuminati, Giulio, D’Urso, Antonio, Fiori, Enrico, Cerasari, Saverio, Nardi, Priscilla, Lapergola, Alfonso, Pasqua, Rocco, Sorrenti, Salvatore, Pironi, Daniele, Lauro, Augusto, D’Andrea, Vito
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Original Article; Surgery
• ISSN: 2038-131X; 2038-3312
• DOI: 10.1007/s13304-023-01476-w

The aim of this study was to retrospectively compare the results of laparoscopy-assisted total gastrectomy (LATG) with those of open total gastrectomy (OTG) for advanced gastric cancer. Patients undergoing total gastrectomy for a T4a, N0-3a-b, M0 gastric adenocarcinoma were divided into two groups. Patients in group A ( n  = 122) underwent LAG, whereas patients in group B ( n  = 109) underwent OTG. Mean length of follow-up was 39 months. Primary study’s endpoints were postoperative mortality and morbidity, overall late survival (OS) and disease-free survival (DFS). Secondary endpoints were the number of retrieved lymph nodes, operating time, intraoperative blood loss, postoperative length of stay (LOS) and the incidence of local recurrence. Twenty-four patients in group A (19.6%) required conversion into OTG. Postoperative mortality was absent in both groups. Postoperative morbidity was 19% in group A and 11% in group B [ p  = 0.19]. OS was 34% in group A and 42% in group B [ p  = 0.21]. DFS was 29% in group A and 33% in group B [ p  = 0.49]. Mean number of retrieved lymph nodes was 29 in group A and 34 in group B [ p