Short-term Surgical Outcomes after Laparoscopic D2 Lymphadenectomy in Patients with Distal Gastric Cancer

ABSTRACT

PURPOSE: With advancements in laparoscopic surgery, there have been efforts to expand the indication for laparoscopic surgery up to advanced gastric cancer. However, scant data are available regarding the feasibility and advantages of laparoscopy-assisted distal gastrectomy (LADG) with standard radical D2 lymph node dissection. MATERIALS AND METHODS: Twenty-two patients who were preoperatively diagnosed with cT1N0M0 gastric cancer underwent LADG with standard D2 lymphadenectomy between February and August 2007. They were compared with patients who underwent conventional open D2 lymphadenectomy with respect to clinicopathologic features, surgical outcomes, and postoperative course. RESULTS: The mean operative time was significantly longer in the LADG group than in the open group (160+/-25 min vs. 135+/-21 min, P<0.001). However, surgical outcomes, such as surgical margin and number of retrieved lymph nodes (25.7+/-11.1 vs. 26.9+/-9.2, P=ns) were comparable between the groups. The LADG group exhibited quicker postoperative recovery, and both groups exhibited similar postoperative morbidity and mortality. CONCLUSION: LADG with D2 lymphadenectomy is feasible and safe, with short-term surgical outcomes comparable to those seen in open D2 lymphadenectomy. Further prospective clinical investigation will be needed to better evaluate the advantages of LADG with D2 lymphadenectomy.