Clinical experience of 528 laparoscopic gastrectomies on gastric cancer in a single institution

Background. Laparoscopic gastrectomy (LG) for locally advanced gastric cancer (AGC) as well as early gastric cancer (EGG) has gradually gained popularity. However, long-term experiences of LG for AGC as well as EGG rarely have been reported. Methods. A total of 528 patients with gastric cancer were enrolled in the study, and clinical experiences of LG were evaluated. Results. The study included 332 men and 196 women. The mean age was 61.3 +/- 11.8 years. Of the 528 patients, 432 underwent distal gastrectomy, 87 had a total gastrectomy, and 9 had a proximal gastrectomy. There were 198 T1a, 139 T1b, 63 T2, 83 T3, and 45 T4a lesions. In 127 patients, lymph node metastasis was observed, and the rate of it was 1.5% in T1a, 12.2% in T1b, 34.9% in T2, 59.0% in T3, and 80.0% in T4a. The median follow-up period was 24 months (range, 1-83 months). The 5-year survival and disease-free survival rates according to the stage of tumor were 99.3% and 97.8% in stage I, 95.4% and 89.7% in stage II, and 44.4% and 31.3% in stage III, respectively. Operation related morbidities occurred in 45 patients, and there were 2 mortalities. Tumors recurred in 36 patients consisting of 2 in T1a, 2 T1b, 2 T2, 12 T3, and 18 T4a. Carcinomatosis peritonei was observed most commonly. Conclusion. In our experience, oncologic results and the safety of LG for EGG and serosa-negative AGC were acceptable. This treatment may be considered as an alternative operative approach. (Surgery 2013;153:611-8.)