Laparoscopic Versus Open D2 Gastrectomy for Gastric Cancer: A Case-Matched Comparative Study.
The role of the laparoscopic approach to D2 gastrectomy for gastric cancer remains controversial. The aim of this study was to compare the operative and short-term oncologic outcomes of laparoscopic versus open resections.  Patients who underwent potentially curative D2 gastrectomy between 2017 and 2019 were retrospectively reviewed. Patients were randomly matched on 1:1 basis for age and extent of surgery (total versus subtotal gastrectomy, and additional organ resection). Exclusions included emergency or palliative surgery. The learning curve for laparoscopic resections was included. Analysis was conducted on intention to treat basis. The outcomes were reported as median (range) or per cent as appropriate.  Among 78 patients who had undergone potentially curative gastrectomy 36 were matched. The groups were comparable for age, sex, American Society of Anesthesiologists (ASA) score, preoperative serum albumin and hemoglobin, body mass index, frequency of previous abdominal surgery, anatomic distribution of disease, extent of gastrectomy, need for additional resection, and disease stage. There was one conversion to open surgery. Although laparoscopic surgery required longer operating time (393 versus 218 minutes, P < .001), it was associated with less blood loss (100 versus 200 mL, P = .001) and shorter hospital stay (3.0 versus 7.5 days, P < .001). There were no significant differences in the rates of clinically significant complications, mortality, readmissions, reoperations, lymph node retrieval, and R1 resections.  The laparoscopic approach to potentially curative D2 gastrectomy for gastric cancer is associated with less operative trauma and quicker recovery while offering an equivalent oncologic resection.
['Ammori|Basil J|BJ|', 'Asmer|Huthaifa|H|', 'Al-Najjar|Hani|H|', 'Al-Bakri|Hebah|H|', 'Dabous|Ali|A|', 'Daoud|Faiez|F|', 'Almasri|Mahmoud|M|']
D000328:Adult D000368:Aged D005260:Female D005743:Gastrectomy D006801:Humans D010535:Laparoscopy D008197:Lymph Node Excision D008297:Male D016555:Matched-Pair Analysis D008875:Middle Aged D012189:Retrospective Studies D013274:Stomach Neoplasms D016896:Treatment Outcome
D2 gastrectomy gastric cancer comparative study laparoscopic surgery hospital stay lymphadenectomy