LAPAROSCOPIC GASTRECTOMY AND LYMPH NODE DISSECTION FOR ADVANCED GASTRIC CANCER
Vo Duy Long MD. PHD, GI surgery department, University Medical Center, Hochiminh city, Vietnam
Laparoscopic gastrectomy is widely used for the treatment of early gastric cancer due to benefits such as shorter hospital stays, less postoperative pain, and faster mobilization… With increasing surgical experience, indications for laparoscopic surgery have been extended to locally advanced tumor stages. Some reports from Hongkong, Korea, Japan show that laparoscopic gastrectomy with D2 lymphadenectomy can be feasibly performed with equivalent overall short- term morbidity and mortality versus the open approach for locally advanced gastric cancer.
Data from meta-analysis suggested that overall short-term mortality and morbidity are not impaired by a minimally invasive approach for gastrectomy for locally advanced gastric cancer as compared with the standard open technique.
At UMC, laparoscopic gastrectomy and D2 lymphadenectomy is indicated for local advanced gastric cancer with T2-4a.
For tumors penetrating the serosa of the posterior gastric wall (T4a), bursectomy may be performed with the aim of removing microscopic tumor deposits in the lesser sac.
There are 550 patients affected gastric adenocarcinoma between Mar 2008 and May 2018 (until Mar 2019: 678 cases), at University Medical Center, Hochiminh city, Vietnam were undergone laparoscopic gastrectomy (446 patients distal and 104 total gastrectomy). The overall postoperative complication rates were 6.5% (36 patients), including anastomotic leak (6 cases), duodenal stump leak (3 cases), postoperative bleeding (3 cases), early intestinal obstruction (2 cases)…The mean hospital length of stay was 7.9 days. One patients was died within 30-post operative period. One-year, three-year and five-year overall survival rates were 93.8%, 85.4% and 68.5%, respectively.