- Laparoscopic total gastrectomy (LTG) for gastric cancer is associated with shorter time to first oral intake and postoperative stay than open surgery, but also a greater incidence of anastomotic leakage.
Why this matters
- LTG has become more commonly performed, but it is technically challenging, and its safety has not been fully established.
- Most prior studies supporting LTG safety were conducted at single institutions.
- Propensity-matched analysis of 12,229 patient pairs derived from the Japanese Diagnosis Procedure Combination database.
- Funding: Government of Japan.
- In-hospital mortality (0.6% vs 0.7%; P=.58) and postoperative complications (17.5% vs 17.3%; P=.66) were similar between groups for propensity-matched patients.
- LTG was associated with higher rates of anastomotic leakage (2.9% vs 1.7%, P<.001 and stenosis vs p=".02)" compared with open surgery.>
- LTG was associated with lower rates of pancreatic injury (1.4% vs 1.8%; P=.01), endoscopic hemostasis (0.9% vs 1.7%; P<.001 blood transfusion vs p and readmission>
- LTG was associated with greater duration of anesthesia (323 vs 304 minutes; P<.001 shorter time to first oral intake days vs p and postoperative length of stay>
- Japanese population.