We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Laparoscopic Surgery of Gastric Cancer with D2 Lymphadenectomy and Omentum Preservation: Our 10 Years Experience.
- Authors
Olmi, Stefano; Uccelli, Matteo; Oldani, Alberto; Cesana, Giovanni; Ciccarese, Francesca; Giorgi, Riccardo; Villa, Roberta; De Carli, Stefano Maria; Zanoni, Adelinda Angela Giulia; Rubicondo, Carolina; Ismail, Ayman
- Abstract
Introduction: The debate is still open about laparoscopic treatment of gastric cancer. The aim of this retrospective study is to analyze our short-, medium-, and long-term surgical and oncological results in laparoscopic treatment of gastric cancer with D2 lymphadenectomy and omentum preservation. Materials and Methods: From January 2010 to June 2018, after >150 surgical procedures for gastric cancer performed by minimally invasive approach, we performed 100 laparoscopic subtotal gastrectomies and 38 total gastrectomies, both for early gastric cancer (EGC) and advanced gastric cancer (AGC). We always made a D2 lymphadenectomy or higher. As often as possible, we performed omentum-preserving technique. Primary outcomes analyzed included incidence of medical and surgical complications. Secondary outcomes analyzed were survival probability and incidence of relapse. Every patient read and signed informed consent before surgery. Results: Mean operative time: 2.4 ± 0.7 hours (range 1.2-4.7 hours). Rate of conversions: 14.5% (20/138); intraoperative complications: 1.4% (2/138) and positive resection margins: 6.5% (9/138). Overall incidence of duodenal fistula: 3.6% (5/138). Rate of reoperation was 7.3% (10/138). Postoperative complications according to Clavien-Dindo classification: I 3.6% (5/138); II 13.0% (18/138); III 5.8% (8/138); III B 0.7% (1/138); V 1.4% (2/138). Overall survival with 60 months follow-up was 58%. Overall 60 months incidence of relapse was 44%. Patients with omentum preservation had a lower incidence of relapse than patients with omentectomy (40% versus 57% P = .002). Conclusions: Laparoscopic treatment of gastric cancer with D2 lymphadenectomy and omentum preservation is safe and feasible, both for EGC and for AGC. Although this study has limitations, omentum-preserving technique was associated with a statistically lower recurrence rate.
- Subjects
LYMPHADENECTOMY; STOMACH cancer; LAPAROSCOPIC surgery; OMENTUM; OPERATIVE surgery; SURGICAL complications; STOMACH tumors; RETROSPECTIVE studies; GASTRECTOMY; TREATMENT effectiveness; LAPAROSCOPY; SURGICAL excision; LYMPH node surgery; LONGITUDINAL method
- Publication
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2020, Vol 30, Issue 7, p749
- ISSN
1092-6429
- Publication type
journal article
- DOI
10.1089/lap.2019.0781