Laparoscopic gastrectomy – pro
Laparoscopic gastrectomy for gastric cancer is rapidly becoming popular because of the technical developments and the accumulatopn of positive data. Laparoscopic distal gastrectomy (LDG) provides better or comparable outcomes compared to conventional open distal gastrectomy (ODG) in terms of short-term results. The long-term survival of LDG is expected to be comparable to that of ODG in early-stage gastric cancer. All this goes more so for minimal tumor burden or early stage disease. Evidence for LDG for advanced gastric cancer is still insufficient and the issue of lack of generalization still remains, even after ongoing multicenter randomized controlled trials. Laparoscopic sentinel node navigation surgery is still experimental and the surgical procedure has yet to be standardized. Robotic gastrectomy is feasible for early gastric cancer in terms of similar outcome, but is much more expensive in comparison to laparoscopic surgery. Its benefit over the conventional laparoscopic gastrectomy has not yet been proven. NICE supports it: ” Current evidence on the safety and efficacy of laparoscopic gastrectomy for cancer appears adequate to support the use of this procedure, provided that normal arrangements are in place for clinical governance, consent and audit. ”
NICE guidance 2014, Laparoscopic gastrectomy for cancer,
Lee H.-J. Yang H.-K., Laparoscopic Gastrectomy for Gastric Cancer,
Dig Surg 2013;30:132-141
Hyung-Ho Kim et al, Long-Term Results of Laparoscopic Gastrectomy for Gastric Cancer: A Large-Scale Case-Control and Case-Matched Korean Multicenter Study JCO March 1, 2014 vol. 32 no. 7 627-633