Surgical And Survival Outcomes Of Laparoscopy-assisted Gastrectomy For Remnant Gastric Cancer

Purpose: The objective of this study is to evaluate the oncologic outcomes of laparoscopy-assisted total gastrectomy for remnant gastric cancer in terms of surgical efficacy and long-term survival.Methods: The study consisted of patients who were prospectively collected and treated with curative intent either via open gastrectomy(35 patients) or laparoscopic gastrectomy(34 patients) between April 2007 and December 2014. Clinicopathological characteristics were retrospectively analyzed, as were surgical and survival outcomes.Results: There was no statistical disparity in clinicopathological parameters between the two cohorts. With respect to perioperative characteristics, blood loss(P=0.002), operation time(P<0.001) and postoperative hospital stay(P=0.012) were significantly lower in the laparoscopic group, while a greater number of dissected lymph nodes were obtained(P=0.048). No significant differences were observed in either time to first flatus or rate of severe complications. The median survival times were 31 months and 25 months in the open and laparoscopic groups, respectively. The difference in 5-year cumulative survival rates did not reach statistical significance, being 45.31% in the open group and 37.96% in the laparoscopic group(P=0.957). In cases of advanced remnant gastric cancer, the 5-year cumulative survival rates were 37.82% and 33.12% in the open and laparoscopic cohorts, respectively; the discrepancy was not statistically significant.Conclusion: With better short-term surgical efficacy, the long-term survival outcomes of laparoscopy-assisted total gastrectomy with D2 lymphadenectomy for remnant gastric cancer was comparable to those of open gastrectomy. The procedure can be used as an efficient and safe procedure for treating remnant gastric cancer.