OBJECTIVE

To compare the results of laparoscopic and laparotomic distal gastrectomies in patients with cancer according to our own experience.

MATERIALS AND METHODS

The paper presents the comparative results of 42 laparoscopic distal gastrectomies and 45 laparotomic distal gastrectomies performed in malignant neoplasms of the stomach. The average age of patients was 63.7±6.3 years in the group of laparoscopic distal gastrectomies and 65.1±5.8 years in the group of laparotomic distal gastrectomies.

RESULTS

Laparoscopic and laparotomic gastric resections did not differ in the number of harvested lymph nodes (21.2±5.1 and 21.3±5.6, respectively, t=0.01; p=0.98). At the same time, laparoscopic operations are accompanied by less intraoperative blood loss (90.3±51.2 ml and 130±71.5 ml with laparotomic access, t=2.45; p=0.04), and laparotomic operations are shorter (126.8±68.3 minutes and 190.4±45.5 minutes with laparoscopic approach, however, the differences are not statistically significant, t=0.77; p=0.28). The period of inpatient treatment is shorter after laparoscopic resections (7.6±3.2 days and 14.2±6.6 days with laparotomic access, t=2.9; p=0.04). Differences in the incidence of postoperative complications (stratified according to the Clavien—Dindo scale and constituting 31.8% for laparoscopic distal gastrectomies and 35.7% for laparotomic surgery) are not statistically significant (χ=0.2; p=0.65). Differences in the frequency of deaths after surgery (constituting 4.7% for laparoscopic operations, and absent in the group of laparotomic interventions) are not statistically significant, F=0.23, p=0.55.

CONCLUSION

Laparoscopic subtotal distal gastrectomy is an effective surgical intervention for cancer of the antrum of the stomach, characterized by an acceptable incidence of postoperative complications and postoperative mortality, while differing from «traditional» gastric resections by the known advantages of laparoscopic operating technologies.