Comparison of laparoscopic distal gastrectomy with open distal gastrectomy for patients with advanced gastric cancer: A single-center analysis from a community hospital

Objective: This study is aimed to investigate the safety and efficacy of laparoscopic distal gastrectomy (LDG) at the community hospital. Summary of Background Data: Although various clinical trials have shown that laparoscopic distal gastrectomy was feasible in patients with early gastric cancer, its safety and efficacy for patients with advanced gastric cancer need to be elucidated. Methods: Patients with pathological Stage IB-III gastric cancer who underwent open distal gastrectomy (ODG) or LDG with D1+ or more extended lymph node (LN) dissection between 2007 and 2014 were eligible for this retrospective study. Patient characteristics, clinicopathologic factors, and post-treatment recurrence were recorded. To evaluate the safety of the surgery, surgical outcomes and postoperative complication were investigated. Results: 638 patients underwent gastrectomy for gastric cancer, with 67 patients included in ODG group and 61 included in LDG group. Patients in the ODG group showed significantly more progressive disease than those in the LDG group. Postoperative infectious complications, [≥Clavien-Dindo (C-D) classification grade III] occurred 6% in all patients, and there was no significant difference between groups. Hospital stay (median, range) was (9, 6–45) in ODG and (7, 5–58) in LDG, with significantly shorter stays in the LDG group (,0.001). Conclusions: LDG could be safely performed for advanced gastric cancer in a community hospital. However, long-term outcomes, including types of postoperative recurrence, need further evaluation.