VOLUME 30 - NUMBER 51 - 2009

Trattamento laparoscopico del carcinoma gastrico: esperienza preliminare

  • Cianchi F., Battisti N., Trallori G., Bonanomi A., Qirici E., Politi L., Perigli G.
  • Articolo Originale, 088-087
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  • Background: In the past decade, several studies have demonstrated the safety and feasibility of laparoscopic surgery for gastric surgery. We analyzed our preliminary experience with this procedure.

    Methods: From July 2007 to December 2009, 11 patients underwent gastrectomy by a mininvasive approach for adenocarcinoma. This series included 6 men and 5 women, aged from 52 to 87 years. Procedures consisted of 9 subtotal gastrectomies and 2 total gastrectomies. According to TNM classification, we observed one patient with non invasive tumor (severe displasia), one with early gastric cancer, three at stage Ib, one at stage II, three at stage IIIa, one at stage IIIb and one at stage IV.

    Results: In all patients the procedures were completed without any conversion. The mean operating time was 270 min (range: 195-370 min). Overall, the mean number of dissected lymph nodes was 23 whereas it was 26 after D2 lymph node dissection. No morbidity was observed. Overall morbidity rate was 18.1% (two cases), one patient with pancreatic fistola and one with bleeding from gastrojejunal anastomosis. Excluding these two patients, postoperative stay was between 8 and 12 days.

    Conclusions: Our preliminary data confirmed that laparoscopic surgery for gastric cancer is a feasible and safe oncologic procedure with short-term results similar to those reported with an open approach. Additional benefits for laparoscopic procedures were reduced blood loss, shorter time to resumption of oral intake and earlier discharge from the hospital.

  • KEY WORDS: gastric cancer, laparoscopic surgery, lymphadenectomy.