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Assessment of open versus laparoscopy-assisted gastrectomy in lymph node-positive early gastric cancer: a retrospective cohort analysis

 Ji Yeong An  ;  Geon-Ung Heo  ;  Jae-Ho Cheong  ;  Woo Jin Hyung  ;  Seung Ho Choi  ;  Sung Hoon Noh 
 JOURNAL OF SURGICAL ONCOLOGY, Vol.102(1) : 77-81, 2010 
Journal Title
Issue Date
Cohort Studies ; Female ; Follow-Up Studies ; Gastrectomy* ; Humans ; Laparoscopy* ; Length of Stay ; Lymph Node Excision ; Lymph Nodes/pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Prospective Studies ; Retrospective Studies ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery* ; Survival Rate
BACKGROUND: Laparoscopy-assisted gastrectomy (LAG) is still limited for early gastric cancer (EGC) with low possibility of lymph node (LN) metastasis, due to the concern for incomplete LN dissection and controversial long-term outcomes. We assessed oncological outcomes of laparoscopy-assisted versus open gastrectomy (OG) for patients with LN positive EGC. METHODS: Between 2003 and 2007, 204 patients underwent surgery for LN positive EGC. We evaluated adequacy of LN dissection and early and long-term outcomes after OG (n = 162) and LAG (n = 42). RESULTS: Operative time was longer but hospital stay was shorter for LAG than OG. Postoperative complications occurred in 14 patients (8.6%) after OG and 1 patient (2.4%) after LAG (P = 0.316). Mean number of retrieved LNs and number of retrieved and metastatic LNs for each station did not differ between the two groups. During median 35 months of follow-up, 14 patients (8.6%) developed recurrence after OG, compared with 4 patients (9.5%) after LAG (P = 0.769). Overall 5-year disease-free survival was 89.9% and 89.7% after OG and LAG. Status of LN metastasis was the only independent prognostic factor for disease-free survival. CONCLUSIONS: LAG is an oncologically safe procedure even for LN positive EGC. Adequate LN dissection and comparable long-term outcomes to OG can be achieved by LAG.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
Heo, Geon Ung(허건웅)
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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