FIVE YEARS OF MINIMALLY INVASIVE GASTRECTOMY IN A SINGLE INSTITUTION - FEASIBILITY AND IMPACT ON MORBIDITY AND MORTALITY COMPARED TO A CONVENCIONAL OPEN APPROACH

Introduction: Gastric cancer is one of the most common cancers today. In Brazil, it is the third most common type among men and the fifth among women. Surgery is the main form of curative treatment for gastric cancer patients. It is indicated in all cases of patients who are candidates for curative treatment and not candidates for endoscopic resection, and an extent of resection is conditioned by analysis of an adequate proximal margin. An abdominal gastrectomy for open adenocarcinoma has been performed since the 1900s in Brazil. Laparoscopic gastrectomy was first recorded in Japan in 1994. Since then, a minimally invasive surgical experience has increased. Objective: To evaluate the results of laparoscopic and robotic gastrectomy in patients with 5-year gastric adenocarcinoma in a single institution. MATERIALS AND Methods: The study included patients with pathological diagnosis of clinical adenocarcinoma of videolaparoscopic or robotic gastrectomy between 2013 and 2018. Immediate results were analyzed (overall morbidity, severe morbidity, mortality, lymph node number). dissected and length of stay) and late (overall survival and disease-free survival) of individuals with minimally invasive gastrectomies. Results: 124 gastrectomies were performed, with a mean age of 59 years. The average number of dissected lymph nodes was 31, and most cases (93.5%) underwent lymphadenectomy in the DII and in only 8 cases of DI lymphadenectomy. Body and antrum tumors were the most common (88.7%). The most common surgery was subtotal gastrectomy (62.9%), followed by total gastrectomy (34.7%) and only three degastrectomies. The standard reconstruction performed at our institution is Roux-en-Y and was performed in 98.4% of cases. Blood transfusion was required in less than 5% of cases. Postoperative complications were present in 34.7% of cases, and a large majority (81.5%) were not required for invasive invasions (endoscopic, surgical or radiological). Conclusion: These findings suggested that minimally invasive surgery for gastric cancer is feasible, clinically impacting recent results of perioperative morbidity and mortality compared to a conventional open approach without cancer impairment.

 

MissingLinkText

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
23 October 2019