Study Compares Laparoscopic With Open D2 Distal Gastrectomy

There was no significant difference in morbidity or mortality between radical laparoscopic distal gastrectomy with D2 lymphadenectomy and open distal gastrectomy D2 lymphadenectomy in patients with advanced gastric cancer, a study published in the Journal of Clinical Oncology has shown.¹

Because the safety and efficacy of radical laparoscopic distal gastrectomy with D2 lymphadenectomy for the treatment of advanced gastric cancer remains controversial, researchers sought to compare laparoscopic and conventional open distal gastrectomy with D2 lymph node dissections.

For the study, researchers enrolled 1056 patients with clinical stage T2-4aN0-3M0 gastric cancer and randomly assigned them to the laparoscopic group or the open D2 distal gastrectomy group. Of note, 15 experienced surgeons performed the operations.

The distribution of severity and the compliance rates of D2 lymphadenectomy were similar between the 2 groups (P = .314 and P = .845, respectively).

Results showed that the 30-day postoperative morbidity rate was 15.2% in the laparoscopic distal gastrectomy arm vs 12.9% in the open distal gastrectomy group (difference, 2.3%; 95% CI, –1.9 – 6.6; P = .285). The mortality rate within 30 days after surgery was 0.4% and 0%, respectively (difference, 0.4%; 95% CI, –0.4 – 1.4; P = .249).

The findings suggested that experienced surgeons can safely perform radical laparoscopic distal gastrectomy with D2 lymphadenectomy in patients with advanced gastric cancer.

Reference

1. Hu Y, Huang C, Sun Y, et al. Morbidity and mortality of laparoscopic versus open D2 distal gastrectomy for advanced gastric cancer: a randomized controlled trial [published online ahead of print February 22, 2016]. J Clin Oncol. doi: 10.1200/JCO.2015.63.7215.