The current status of laparoscopic resection for gastric cancer

Abstract

The role of laparoscopy and laparoscopic treatment for gastric cancer has evolved. Diagnostic laparoscopy is a useful tool for accurate staging for gastric cancer and may reduce the incidence of unnecessary laparotomy. In Japan, where early gastric cancer (EGC) is common, various endoscopic and laparoscopic techniques for resection of EGC have been developed Laparoscopic radical gastrectomy for cancer was first performed in 1993. Between September 1997 and August 1999, we have performed three cases of total laparoscopic radical subtotal gastrectomy and one case of laparoscopic total gastrectomy for patients with gastric carcinoma. The median duration of surgery was 210 minutes (range: 180-260) and pathologically one of our patients was staged IIIA, one IIB and two were staged IIA. There were no complications and the median postoperative stay in the hospital was 7 days (range 6-9 days). The mean number of lymph nodes retrieved was 21 (range 17-26). No recurrence was found in the follow-up visits. Our experience and other series in the literature demonstrated that laparoscopic radical gastrectomy for cancer is safe and feasible. However, the benefit is uncertain, as this procedure is technically demanding and is costly.