Comparison between open and laparoscopic gastrectomy for gastric cancer: A monocentric retrospective study from a western country
Résumé
Background: The majority of laparoscopic gastrectomy (LG) reports arise from Asia and the benefit of this approach in western countries remains unclear. The objective of this study was to compare the postoperative outcomes between LG and open gastrectomy (OG) for gastric cancer in a western center. Methods: Between 2005 and 2015, all consecutive patients with gastric cancer who underwent either LG or OG were enrolled. Postoperative morbimortality was evaluated according to Dindo-Clavien classification. Results: Over 164 patients, 60 had LG and 104 OG with a mean age of 62 and 65 years, respectively. Total gastrectomy represented 58% of LG and 54% of OG (P = 0.749). Operative time was not different in the two groups (160.8 vs. 174.2 min, P = 0.780) so as intraoperative blood loss (111 vs. 173 mL, P = 0.057). The rate of severe complications (including postoperative bleeding) was significantly higher in the LG group (40% vs. 23%, P = 0.012) so as reoperation rate (27% vs. 6%, P < 0.001). There was no statistical difference m terms of postoperative mortality (0 vs. 3%, P = 0.252) or length of hospital stay (20 vs. 16 days, P = 0.116). Conclusion: Laparoscopic gastrectomy for the treatment of gastric cancer in western countries appears to be feasible but with a higher rate of severe complications compared to open gastrectomy. (C) 2017 Elsevier Masson SAS. All rights reserved.