Evaluation of laparoscopic total gastrectomy for advanced XXXX : results of a comparison with laparoscopic distal gastrectomy.

@entity1 @entity356 @entity260
OBJECTIVE: To validate the efficacy and safety of laparoscopic total gastrectomy (LTG) for advanced @entity356 (AGC). BACKGROUND: Laparoscopic distal gastrectomy (LDG) in the treatment of @entity1 with local AGC is becoming increasingly popular, and there have been several multicenter randomized controlled trials focused on this treatment. However, few reports on the procedure of LTG for AGC exist. METHODS: The data of 976 @entity1 who underwent LTG for AGC were retrieved from a prospectively constructed database of 2170 @entity1 who underwent laparoscopic gastrectomy between 2007 and 2013. Surgical outcomes of LTG were investigated and compared with those of @entity1 who underwent LDG. RESULTS: LTG was associated with significantly longer operation time, number of dissected lymph nodes, and time of resume soft diet compared with the LDG group. According to Clavien-Dindo classification, the morbidity and mortality rates of the LTG group were comparable to those of the LDG group. Multivariate analyses revealed that elderly @entity1 , more comorbidities, and longer operation time were the significant independent risk factors for @entity260 . The difference in overall survival rates between the two groups was statistically significant. However, a comparative analysis of overall survival showed no statistical significance for any of the stages of cancer between the LTG and LDG groups. CONCLUSIONS: The study findings suggest that LTG is an oncologically safe procedure for AGC yields comparable surgical outcomes. A well-designed phase III trial can be carried out to provide valuable evidence for the oncologic safety of LTG for the treatment of AGC.
