PT  - JOURNAL ARTICLE
AU  - Julie Hallet
AU  - Saber Labidi
AU  - Antoine Bouchard-Fortier
AU  - Ariane Clairoux
AU  - Jean-Pierre Gagné
TI  - Oncologic specimen from laparoscopic assisted gastrectomy for gastric adenocarcinoma is comparable to D1-open surgery: the experience of a Canadian centre
AID  - 10.1503/cjs.002612
DP  - 2013 Aug 01
TA  - Canadian Journal of Surgery
PG  - 249--255
VI  - 56
IP  - 4
4099  - http://canjsurg.ca/content/56/4/249.short
4100  - http://canjsurg.ca/content/56/4/249.full
SO  - CAN J SURG2013 Aug 01; 56
AB  - Background: The Eastern experience has reported the safety of laparoscopic assisted gastrectomy (LAG) for gastric cancer. Its use in Western countries is still debated owing to concerns about its oncologic equivalence to open gastrectomy (OG). We sought to review and compare their operative outcomes and oncologic specimen quality (number of harvested lymph nodes and surgical margins) for gastric adenocarcinoma (GA).Methods: We reviewed the charts of all patients undergoing LAG (2007–2010) and OG (2000–2010) for GA in a single institution. Several surgeons performed the OGs, whereas 1 fellowship-trained laparoscopic surgeon performed LAGs. The primary outcome was quality of the surgical specimen, assessed by the number of harvested lymph nodes (LNs) and margin status. Secondary outcomes were perioperative events. Data were analyzed as intention to treat.Results: We retrieved 60 cases (47 OGs, 13 LAGs). The conversion rate was 23%. Mean operative time was 115 minutes longer and blood loss was 425 mL less (both p < 0.001) for LAGs. A mean of 14.4 (standard deviation [SD] 9.8) and 11.2 (SD 8.2) LNs were harvested for OGs and LAGs, respectively (p = 0.29). Negative margins were achieved for all patients. Mean length of stay was similar (LAG: 19 d v. OG: 18.9 d; p = 0.91). The groups did not differ on major postoperative complications (12.7% v. 23.1%; p = 0.39) or operative mortality (2.1% v. 7.7%; p = 0.32).Conclusion: Laparoscopic assisted gastrectomy is a challenging but safe and feasible procedure in experienced hands. It offers the same radical resection as OG regarding negative margins and LN retrieval. Long-term follow-up is warranted.