Minimally invasive versus open surgery for gastric cancer in Turkish population
Orhan Ağcaoğlu1, Berke Şengün1, Serim Tarcan2, Erman Aytaç2, Onur Bayram1, Serkan Zenger3, Çiğdem Benlice2, Volkan Özben2, Emre Balık1, Bilgi Baca2, İsmail Hamzaoğlu2, Tayfun Karahasanoğlu2, Dursun Buğra1
1Department of General Surgery, Koç University Faculty of Medicine, Istanbul, Turkey
2Department of General Surgery, Acibadem Mehmet Ali Aydinlar University Faculty of Medicine, Istanbul, Turkey
3Medical Department of General Surgery, American Hospital, Istanbul, Turkey
Objective: In this study, it was aimed to compare short-term outcomes of minimally invasive and open surgery for gastric cancer in the Turkish population carrying both European and Asian characteristics.
Material and Methods: Short-term (30-day) outcomes of the patients undergoing minimally invasive and open gastrectomy with D2 lymphadenec- tomy for gastric adenocarcinoma between January 2013 and December 2017 were compared. Patient demographics, history of previous abdominal surgery, comorbidities, short-term perioperative outcomes and histopathological results were evaluated between the study groups.
Results: There were a total of 179 patients. Fifty (28%) patients underwent minimally invasive [laparoscopic (n= 19) and robotic (n= 31)] and 129 (72%) patients underwent open surgery. There were no differences between the two groups in terms of age, sex, body mass index and ASA scores. While operative time was significantly longer in the minimally invasive surgery group (p< 0.0001), length of hospital stay and operative morbidity were com- parable between the groups.
Conclusion: While both laparoscopic and robotic surgery is safe and feasible in terms of short-term outcomes in selected patients, long operating time and increased cost are the major drawbacks of the robotic technique preventing its widespread use.
Keywords: Gastric cancer, laparoscopic surgery, robotic gastrectomy, D2 dissection, minimally invasive