National Trend in Laparoscopic Gastrectomy for Gastric Cancer: Analysis of the National Register in Chile

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Introduction: The laparoscopic approach for the treatment of gastric cancer has many advantages. However, outside Asia there are few large case series. Aim: To evaluate postoperative morbidity, long-term survival, changes in indication, and the results of laparoscopic gastrectomy. Methods: We included all patients treated with a laparoscopic gastrectomy from 2005 to 2014. We compared results across 2 time periods: 2005–2011 and 2012–2014. Median follow-up was 39 months. Results: Two hundred and eleven patients underwent a laparoscopic gastrectomy (median age 64 years, 55% male patients). In 135 (64%) patients, a total gastrectomy was performed. Postoperative morbidity occurred in 29%. A significant increase in the indication of laparoscopic surgery for stages II–III (32 vs. 45%; p = 0.04) and higher lymph node count (27 vs. 33; p = 0.002) were observed between the 2 periods. The 5-year overall survival was 72%. According to the stage, the 5-year overall survival was 85, 63, and 54% for stage I, II, and III respectively (p < 0.001). Conclusions: There was an acceptable rate of postoperative complications and the long-term survival was in accordance with the disease stage. There was a higher indication of laparoscopic surgery in stages II–III disease, and higher lymph node count in the latter period of this study.

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