Comparison of the long-term results of patients who underwent laparoscopy versus open distal gastrectomy

Background: Survival data of patients who underwent laparoscopy assisted distal gastrectomy (LADG) compared with those of patients who underwent open distal gastrectomy (ODG) for gastric cancer are rarely presented. We compared long-term outcomes of LADG with those of ODG in patients with EGC who met the current indication for LADG. Methods: A total of 2410 patients with early gastric cancer who underwent curative-intent gastric cancer surgery in three Korean tertiary hospitals between January 2003 and June 2009 were included in this multicenter, retrospective, propensity-score-matched cohort study. Cox proportional hazard regression models were used to evaluate the association between operation methods and survival. Results: In the matched cohort, there were no significant differences in overall survival [hazard ratio (HR) for the LADG group 0.990; 95 % confidence interval (CI) 0.675–1.453] or recurrence-free survival (HR 0.989; 95 % CI 0.480–2.038). The patterns of recurrence were not different between the two groups. The most common pattern of recurrence was liver metastasis followed by metastasis to distant lymph nodes. The rate of complications in the LADG group was higher than that of the ODG group (6.7 vs. 4.6 %, P = 0.045). Grade III or worse complications that required surgical intervention or were life-threatening showed a marginal difference between the two groups (1.7 vs. 2.2 %, P = 0.052). There were no postoperative mortalities in either group. Conclusion: Laparoscopy assisted distal gastrectomy for patients with early gastric cancer is feasible in terms of the long-term results including survival and recurrence.