Laparoscopic Gastrectomy for Gastric Cancer with Simultaneous Organ Resection

초록

Objectives: Simultaneous organ resection is performed in 10% of laparoscopic gastrectomies for gastric cancer. The purpose of this study is to investigate the feasibility and safety of simultaneous organ resection with laparoscopic gastrectomy for gastric cancer. Subjects and Methods: We retrospectively reviewed the medical records from a prospectively collected database of patients who underwent laparoscopic gastrectomy from May 2003 to April 2012 in a single center. The patients were classified into three groups: a gastrectomy-only (no simultaneous resection [NS]) group as a control, a combined resection (CB) group characterized by additional resection due to tumor invasion and extensive lymphadenectomy, and a concomitant resection (CC) group, including patients with other pathologic conditions. The clinical outcomes, in particular morbidity and mortality, were compared among the three groups. Results: The NS, CB, and CC groups included 1883 (90.1%), 66 (3.2%), and 140 (6.7%) patients, respectively. Mean operation time was longer in CB and CC patients than in NS patients (233.059.3, 227.4 +/- 100.9, and 180.1 +/- 54.0 minutes, respectively; P<.001), and mean hospital stay was longer in the CB and CC groups than in the NS group (9.6 +/- 5.2, 8.3 +/- 4.7, and 6.9 +/- 4.4 days, respectively; P<.001). However, there were no statistically significant differences among the groups in the incidence of complications (P=.185), complications more severe than grade II (P=.077), and mortality (P=1.000). Conclusions: Laparoscopic simultaneous organ resection during laparoscopic gastrectomy for gastric cancer prolonged the operation time and hospital stay but did not increase morbidity and mortality.

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