Laparoscopic gastrectomy with D2 lymphadenectomy for gastric cancer: Short-term results from a tertiary hospital in Vietnam

Abstract

Objectives: We performed this study to determine the early success and outcomes of totally laparoscopic gastrectomy (TLG), dissecting the lower part of the stomach to treat gastric cancer. Materials and Methods: Clinical data, preoperative diagnosis, evaluation of intraoperative lesions, surgical techniques, postoperative pathology, and surgical results of 106 gastric cancer patients who underwent TLG and Billroth II gastrojeju-nal-anastomosis with a Hofmeister-Finsterer reconstruction and D2 lymphadenectomy from January 2019 to August 2020 were recorded and analyzed using SPSS 17.0. We used the Japanese Gastric Cancer Association standards for the clinical and pathological definitions. Results: Of the 106 cases, 76 were males and 30 were females. The average age was 59.33 ± 12.20 years, and the average duration of surgery was 136.37 ± 26.08 minutes. The estimated blood loss was 18.08 ± 10.95 mL. The average length of hospital stay was 8.63 ± 3.89 days. The average post-surgical time to pass flatus was 4.18 ± 1.4 days and that of restarting diet was 3.27 ± 1.08 days. There were no intraoperative complications, and no laparotomy was required. Gastrointestinal anastomosis was performed with Hofmeister-Finsterer reconstruction. General postoperative complications consisted of seven (6.58%) cases: one (0.94%) anastomotic leakage, one (0.94%) gastrojejuno-colic fistula, three (2.82%) early small bowel obstructions, and two (1.89%) late small bowel obstructions. No intra-abdominal bleeding, duodenal stump leakage, pancreatitis, surgical site infections, intra-abdominal abscesses, or fatal cases were recorded. Conclusions: Totally laparoscopic gastrectomy (TLG) treating stomach cancer and D2 lymphadenectomy has shown positive results, with a low postoperative complication rate and safe implementation process to help patients achieve faster recovery and a shorter hospital stay.