A Comparative Study between Open and Laparoscopic Gastrectomy with D2 Lymph Node Dissection in Gastric Cancer
Wisit Kasetsermwiriya MD1, Nut Tongbuasirilai MD1, Piya Teawprasert MD, Msc1, Suphakarn Techapongsatorn MD, Msc1, Amarit Tansawet MD1, Satit Srimonthayamas MD1
Affiliation : 1 Department of Surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Objective : To compare the early postoperative results of gastrectomy with D2 lymph node dissection in terms of operative
time, complications and the number of harvested lymph nodes between the open and laparoscopic approaches.
Materials and Methods : Data of 38 patients with gastric cancer who underwent surgery from 2010 to 2015 were reviewed.
Twenty-two patients who underwent successful laparoscopic surgery [LG] were compared with 16 patients who underwent
open surgery [OG] in terms of operative time, intra-operative blood loss, rates of complications, length of hospital stay and
the number of harvested lymph nodes.
Results : The clinicopathological characteristics between the LG group and the OG group were similar. The LG group
required longer operative time (280 min in OG vs. 390 min in LG, p = 0.010) but experienced less volume of blood loss (200
ml in LG vs. 500 ml in OG, p = 0.002). Volume of blood transfusion was also significantly less in the LG group (p = 0.012).
The length of hospital stay, number of harvested lymph nodes, rates of postoperative death and complications were not
different between the two groups.
Conclusion : Laparoscopic gastrectomy with D2 lymph node dissection was a safe procedure with morbidity and mortality
rates comparable to open surgery.
Keywords : Gastric cancer, Laparoscopic D2 gastrectomy, Low incidence country, Safety
