Laparoscopic Access in Radical Surgical Treatment of Complicated Gastric Cancer: a Single-Center Experience

Over the past decades, there has been an active introduction of minimally invasive surgical technologies in the treatment of various diseases, including gastric cancer. In Asian countries and Europe, laparoscopic gastrectomy is an alternative to open gastrectomy for early gastric cancer, with a tendency to displace the latter. In the Russian Federation, laparoscopic gastrectomy is performed in a few specialized centers. From 2013 to 2022, the surgeons of our Center treated 141 patients diagnosed with gastric cancer at different stages (64 men, 39 women, mean age of 60.5±10 years). Of these, 52 patients (50.5%) underwent open surgeries (group I), 51 (49.5%) — laparoscopic surgeries (group II). The study included patients diagnosed with gastric cancer complicated by bleeding or gastric outlet/cardioesophageal junction obstruction, over 18 years of age, who signed consent for the processing of personal data and inclusion of their clinical data in the research and underwent surgical treatment. We analyzed such parameters as the duration of surgical intervention and the duration of hospital stay, the rates of hospital/relapse-free 2-year survival, and uncomplicated postoperative period. Laparoscopic-assisted surgeries lasted longer; however, due to more precise technique and better visualization of anatomical structures, there was a smaller volume of intraoperative blood loss. During laparoscopic-assisted radical gastrectomy, it is possible to perform more precise lymph node dissection, increase the number of harvested lymph nodes and, thus, increase the probability of detecting lymph nodes with metastases; which, in turn, has a direct impact on increasing the 2-year relapse-free and 2-year overall survival of patients. There was no significant difference in the incidence or severity of postoperative complications and mortality. These data are an important indicator of the effectiveness of the minimally invasive surgical method of treatment, which indicates greater safety of the laparoscopic method compared to intervention from laparotomy access.