Long-Term Results and Current Problems in Laparoscopic Gastrectomy: Single-Center Experience

Abstract

Introduction: The study aims to evaluate the long-term results of patients who underwent laparoscopic gastrectomy for gastric cancer in Ankara University Medical Faculty, Surgical Oncology Clinic, within 5 years. Materials and Methods: We retrospectively reviewed the data of patients who underwent laparoscopic gastrectomy for gastric cancer at the Surgical Oncology Clinic of Ankara University Medical Faculty between January 2014 and September 2019. One hundred forty-six patients were included in the study. Results: Fifty-one (34.9%) of the patients were female; 95 (65.1%) were male. The mean ± standard deviation and median (minimum-maximum) values of the patients were 60.92 ± 14.13 and 64.00 (22.00-93.00), respectively (Table 1). Eighty-seven (59.6%) cases were located in the antrum, 29 (19.9%) were in the cardia region, and 30 (20.5%) were in the corpus region. Overall, 106 (72.6%) of 146 patients were alive, while 40 (27.4%) were ex. The mean survival was 21.8 months (0-69). Postoperative mortality was seen in 9 patients (6.2%) and our disease-free survival rate was 70.5%. Recurrence occurred in 14 (9.6%) of all patients. Patient Characteristics Variables Age Mean ± SD 60.92 ± 14.13 †Median (min.-max.) 64.00 (22.00-93.00) Albumin Mean ± SD 3.90 ± 0.51 †Median (min.-max.) 4.00 (2.50-5.01) Met lymph count Mean ± SD 8.41 ± 7.05 †Median (min.-max.) 6.00 (1.00-40.00) Total lymph count Mean ± SD 23.09 ± 8.97 †Median (min.-max.) 22.00 (4.00-52.00) Survival Mean ± SD 21.83 ± 17.40 †Median (min.-max.) 17.50 (0.10-69.00) Gender, n (%) †Man 95 (65.1) †Woman 51 (34.9) Morbidity, n (%) †No 117 (80.1) †Yes 29 (19.9) TM location, n (%) †Antrum 87 (59.6) †Cardia 39 (19.9) †Corpus 30 (20.5) Operation, n (%) †Subtotal 103 (70.5) †Total 43 (29.5) Anastomosis, n (%) †Open 6 (4.1) †Intracorporeal 54 (37.0) †Mini-laparotomy 86 (58.9) Sur comp, n (%) †No 131 (89.7) †Yes 15 (10.3) T, n (%) †1 32 (21.9) †2 18 (12.3) †3 55 (37.7) †4 41 (28.1) N, n (%) †Negative 68 (46.6) †Positive 78 (53.4) Mortality, n (%) †No 106 (72.6) †Yes 40 (27.4) Recurrence, n (%) †No 132 (90.4) †Yes 14 (9.6) Conclusion: In conclusion, although laparoscopic gastrectomy is a reliable and feasible method for gastric cancer, the standardization of laparoscopic surgery is required in clinics.