Laparoscopic Gastrectomy for Stomach Cancer

Approximately 22,000 people are diagnosed with gastric adenocarcinoma each year in the United States. Currently, surgical resection is the only potentially curative treatment for this patient group. When treating individuals with gastric cancer, the goal is to perform a successful oncologic resection safely while preserving patients’ quality of life. Some controversies exist regarding the treatment strategy and methods physicians use to perform the resection, particularly over the decision on whether or not laparoscopic gastrectomy is appropriate. Open gastrectomy is the most commonly used surgery in patients with resectable adenocarcinoma, but a laparoscopic approach has shown efficacy as an alternative. In fact, it may even be a preferable treatment option for select patient populations. In the April 4, 2009 Annals of Surgical Oncology, my colleagues and I compared the technical feasibility and oncologic efficacy of laparoscopic gastrectomy with open subtotal gastrectomy for gastric adenocarcinoma. As one of the largest U.S. studies of laparoscopic gastrectomy to date, our investigation demonstrated that the procedure appears to be both safe and effective. Comparing Gastrectomy Techniques In our analysis, we studied the operative characteristics and short-term oncologic and surgical outcomes of patients who underwent laparoscopic gastrectomy as compared with those who underwent open gastrectomy. Despite a longer median operative time, the minimally invasive approach was associated with the following: • Decreased length of hospital stay. • Reduced need for postoperative pain relief. • Fewer complications. • Comparable rates of recurrence-free survival after 36 months follow-up. Additionally, the short-term oncologic results yielded equivalent margin status and adequate lymph node retrieval. This is a critical aspect of cancer surgery—in order to stage patients appropriately and determine...