Comparative study of laparoscopic vs open gastrectomy in gastric cancer management

AIM:To compare long-term results of gastric cancer patients undergoing laparoscopic and open gastrec-tomy in a single unit.METHODS:From February 2000 to September 2004,all patients with adenocarcinoma of the stomach were assessed to entry in this longitudinal prospective non-randomized trial.Primary endpoint was cancer-related survival and secondary endpoints were overall survival,evaluation of surgical complications and mortality.RESULTS:Fifty-eight patients were enrolled.Forty-seven patients were followed-up(range 11-103,me-dian 38 mo).Four patients were lost at follow up.Twenty-two patients underwent a laparoscopic gastric surgery(LGS)and 25 had a standard open procedure(OGS).No statistical difference was found between the two groups in terms of 5 years cancer-related mortality rate(50% vs 52%,P = 1),and 5 years overall mortal-ity rate(54.5% vs 56%,P = 1).Accordingly,cancer-related and overall survival probability by Kaplan-Meier method showed comparable results(P = 0.81 and P = 0.83,respectively).We found no differences in surgical complications in the 2 groups.There was no conversion to open surgery in this series.CONCLUSION:LGS is as effective as OGS in the man-agement of advanced gastric cancer.However LGS can-not be recommended routinely over OGS for the treat-ment of advanced gastric cancer.