Comparison of open and laparoscopic gastrectomy for gastric cancer: a low volume center experience
Adem Yüksel1, Murat Coşkun2, Hamdi Taner Turgut2, Fatih Sümer3
1Clinic of Gastroenterological Surgery, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
2Clinic of General Surgery, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
3Department of Gastroenterological Surgery, Inonu University School of Medicine, Malatya, Turkey
Objective: In gastric cancer, laparoscopic gastrectomy is commonly performed in Asian countries. In other regions where tumor incidence is relatively low and patient characteristics are different, developments in this issue have been limited. In this study, we aimed to compare the early results for patients who underwent open or laparoscopic gastrectomy for gastric cancer in a low volume center.
Material and Methods: We retrospectively analyzed the data of patients who underwent curative gastric resection (open gastrectomy n: 30; laparoscopic gastrectomy n: 30) by the same surgical team between 2014 and 2019.
Results: The tumor was localized in 60% (36/60) of the patients in the proximal and middle 1/3 stomach. In laparoscopic gastrectomy group, the operation time was significantly longer (median, 297.5 vs 180 minutes; p< 0.05). In open gastrectomy group, intraoperative blood loss (median 50 vs 150 ml; p< 0.05) was significantly higher. Tumor negative surgical margin was achieved in all cases. Although the mean number of lymph nodes harvested in laparoscopic gastrectomy group was higher than the open surgery group, the difference was not statistically significant (28.2 ± 11.48 vs 25.8 ± 9.78, respectively; p= 0.394). The rate of major complications (Clavien-Dindo ≥ grade 3) was less common in the laparoscopic group (6.7% vs 16.7%; p= 0.642). Mortality was observed in four patients (2 patients open, 2 patients laparoscopic).
Conclusion: In low-volume centers with advanced laparoscopic surgery experience, laparoscopic gastrectomy for gastric cancer can be performed with the risk of morbidity-mortality similar to open gastrectomy.
Keywords: Gastric cancer, laparoscopic gastrectomy, open gastrectomy, complication
Cite this article as: Yüksel A, Coşkun M, Turgut HT, Sümer F. Comparison of open and laparoscopic gastrectomy for gastric cancer: a low volume center experience. Turk J Surg 2021; 37 (1): 6-13.
The approval for this study was obtained from Healt Sciences University Kocaeli Derince Training and Research Hospital Clinical Research Ethics Committee (Decision no: 2019-98 Date: 14.11.2019).
Concept - A.Y., M.C.; Design - A.Y., H.T.T., M.C.; Supervision - F.S.; Data Collection and/or Processing - A.Y., M.C.; Analysis and Interpretation - A.Y., H.T.T.; Literature Review - A.Y., F.S., H.T.T.; Writing Manuscript - A.Y.; Critical Reviews - A.Y., F.S.
The authors declare that they have no conflict of interest.
The authors declared that this study has received no financial support.