Laparoscopy in surgical management of gastric cancer: A single center experience

Accept Date 2019-10-15 ABSTRACT Background: Gastric cancer is the fourth most common cancer worldwide. Laparoscopic Gastrectomy is technically demanding surgery and its adequacy for lymph node clearance is controversial. The present work aims to evaluate feasibility and effectiveness of the laparoscopic method in treating gastric cancer. Methods: A total sample of 15 patients presenting with non-metastatic cancer stomach were included in the study. Ages less than 15 years or older than 70 were excluded. Laparoscopic total gastrectomy and esophagojejunostomy was performed for proximal types of cancer, while laparoscopic subtotal gastrectomy with gastrojejunostomy and entero-enterostomy was done for distal stomach cancer. Results: Mean age was 55.87+7.37 with male predominance (80%) and 26.7% were diabetics. Distal stomach cancer was the most prevalent type (73.3%). Total gastrectomy was done in 3 patients, subtotal gastrectomy in 11 patients, partial gastrectomy in 1 patient of Gist tumor. The mean operative time was 251.87+24.14 while average blood loss ranged from 150 to 310ml. Chest infection occurred in 2 patients, while wound infection and anastomotic leakage occurred in 1 patient each. Surgical margins were clear in 100% of patients (14.8+2.42 lymph node dissected). Adenocarcinoma was the commonest pathological type (60%). Mean hospital stay was 6.53 days while time to start oral feeding ranged from 2 to 5 days. Conclusion: Total laparoscopic gastrectomy is safe and effective, and offers some advantages as low intra-operative blood loss and overall complication rates; few wound-related complications; quick recovery of gastrointestinal motility and a short hospital stay, but with a long operating time.