Role of laparoscopic surgery in cancer of stomach: Our early experience
Abstract
Purpose: To study the clinical outcome and scope of laparoscopic management in patients of cancer stomach.
Methods: This is a prospective study of our first 25 patients of cancer stomach managed laparoscopically. Following procedures were undertaken: 1) Gastric resection in resectable cases; 2) Palliative bypass; 3) Tumor/ nodal/ peritoneal/ any other/ biopsy in cases of unresectable tumors.
Results: Growth was resectable in 10 (40%) patients, and unresectable in 15 (60%) patients. Diagnostic laparoscopy had sensitivity of 100%, while other modalities of investigation were not totally useful in 1/3 to ½ of cases. Laparoscopic gastrojejunostomy was done in 5 (20%) patients, laparoscopy assisted distal partial gastrectomy was performed in 8 (32%) patients while totally laparoscopic gastrectomy was possible in 1 (4%) patient. Long term follow up was observed.
Conclusion: In cancer stomach laparoscopy is a safe, effective, and cost effective means of directing appropriate therapy especially in patients requiring diagnostic, staging and palliative procedures.
Keywords
Full Text:
PDFReferences
Nandkumar A, Dhar M. Five year consolidated report of the hospital based cancer registries 1994-1998. National Cancer Registry Programme. 2002; 1:4-18.
Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994;4:146-8.
Kitano S, Shiraishi N, Fujii K, et al. A randomized controlled trial comparing open vs laparoscopy-assisted distal gastrectomy for the treatment of early gastric cancer: An interim report. Surgery. 2002;131:S306-11.
Hayashi H, Ochiai T, Shimada H, Gunji Y. Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancer. Surg Endosc. 2005;19:1172-6.
Kim HH, Hyung WJ, Cho GS, et al. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: An interim report--a phase III multicenter, prospective, randomized Trial (KLASS Trial). Ann Surg. 2010; 251: 417-20.
Lee JH, Han HS. A prospective randomized study comparing open vs laparoscopy-assisted distal gastrectomy in early gastric cancer: Early results. Surg Endosc. 2005;19: 168-73.
Brady PG, Peebles M, Goldschmid S. Role of laparoscopy in the evaluation of patients with suspected hepatic or peritoneal malignancy. Gastrointest Endosc. 1991; 37:27-30.
Roukos DH. Current advances and changes in treatment strategy may improve survival and quality of life in patients with potentially curable gastric cancer. Ann Surg Oncol. 1999;6:46-56.
Griffith JP, Sue-Ling HM, Martin I, et al. Preservation of spleen improves survival after radical surgery for gastric cancer. Gut. 1995; 36: 684-90.
Cuschieri A, Fayers P, Fielding J, et al. Postoperative morbidity and mortality after D1 and D2 resection for gastric cancer: preliminary results of the MRC randomized controlled surgical trial. The Surgical Cooperative Group. Lancet. 1996; 347: 995-9.
Kim YW, Baik YH, Yun YH, et al. Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg. 2008; 248:721-7.
Hwang SI, Kim HO, Yoo CH, et al. Laparoscopic-assisted distal gastrectomy versus open distal gastrectomy for advanced gastric cancer. SurgEndosc. 2009; 23: 1252-8.
Han JH, Lee HJ, Suh YS, et al. Laparoscopy-assisted distal gastrectomy compared to open distal gastrectomy in early gastric cancer. Dig Surg. 2011; 28: 245-51.
Chun HT, Kim KH, Kim MC, Jung GJ. Comparative study of laparoscopy-assisted versus open subtotal gastrectomy for pT2 gastric cancer. Yonsei Med J. 2012; 53: 952-9.
Kajitani T. The general rules for the gastric cancer study in surgery and pathology. Part I. Clinical classification. Jpn J Surg. 1981;11:127-39.
Burke EC, Karpheh MS, Conlon KC. Laparoscopic in the management of Gastric adenocarcinoma. Ann Surg. 1997;225:262-7.
Molloy RG, McCourtney JS, Anderson JR. Laparoscopy in the management of patients with cancer of the cardia and oesophagus. Br J Surg. 1995; 82:352-4.
Gemmill EH, McCulloch P. Systemic review of minimally invasive resection for GE cancer. Br J Surg. 2007; 94: 1461-7.
Pugliese R, Maggioni D, Sansonna F, et al. Outcomes and survival after laparoscopic gastrectomy for adenocarcinoma. Analysis on 65 patientsoperated on by conventional or robot-assisted minimal access procedures. Eur J Surg Oncol. 2009;35:281-8.
Dulucq JL, Wintringer P, Stabilini C, et al. Laparoscopic and open gastric resection for malignant lesions: a prospective comparative study. Surg Endosc. 2005; 19:933-8.
Adachi Y, Shiraishi N, Shiromizu A, et al. Laparoscopy –assisted Billroth I gastrectomy compared with conventional open gastrectomy. Arch Surg. 2000; 135:806-10.
Kitano S, Shiraishi N, Fujii K, et al. A randomized controlled trial comparing open vs laparoscopy-assisted disral gastrectmy for the treatment of early gastric cancer: an interim report. Surgery. 2002; 131:306-11.
DOI: http://dx.doi.org/10.14319/ijcto.33.20

This work is licensed under a Creative Commons Attribution 3.0 License.
International Journal of Cancer Therapy and Oncology (ISSN 2330-4049)
© International Journal of Cancer Therapy and Oncology (IJCTO)
To make sure that you can receive messages from us, please add the 'ijcto.org' domain to your e-mail 'safe list'. If you do not receive e-mail in your 'inbox', check your 'bulk mail' or 'junk mail' folders.