Gastrectomía totalmente laparoscópica por neoplasias gástricas: Experiencia en un centro público

• Enrique Norero ^[1] ; Sergio Báez ^[1] ; Eduardo Briceño ^[1] ; Cristian Martínez ^[1] ; Marco Ceroni ^[1] ; Alex Escalona ^[1] ; Gloria Aguayo ^[2] ; Paulina González ^[1] ; Fernando Araos ^[3] ; Alfonso Calvo ^[1] ; Alfonso Díaz ^[1] ; Eduardo Viñuela ^[1]
  1. [1] Servicio de Salud Metropolitano Sur Oriente Hospital Sótero del Río Departamento de Cirugía Digestiva
  2. [2] Servicio de Salud Metropolitano Sur Oriente Hospital Sótero del Río Servicio de Anatomía Patológica
  3. [3] Servicio de Salud Metropolitano Sur Oriente Hospital Sótero del Río Servicio de Radiología

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• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 143, Nº. 3, 2015, págs. 281-288
• Idioma: español
• Títulos paralelos:
  • Totally laparoscopic gastrectomy for the treatment of gastric tumors
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• Resumen

  • Background: The laparoscopic approach for the treatment of gastric tumors has many advantages. Aim: To evaluate the results of a laparoscopic gastrectomy program developed in a public hospital. Patients and Methods: Retrospective review of epidemiological, perioperative and follow-up data of patients who were treated with a laparoscopic gastrectomy due to gastric tumors between 2006 and 2013. A totally laparoscopic technique was used for all cases. Complications were evaluated according to the Clavien-Dindo classification. Results: Fifty one patients, aged 65 (36-85) years, underwent a laparoscopic gastrectomy. In 22 patients a total gastrectomy was performed. Conversion rate to open surgery was 8%. Operative time was 330 (90-500) min and bleeding was 200 (20-500) ml. Median hospital stay was 7 (3-37) days. Postoperative morbidity was present in 17 (33%) patients, 3 (6%) patients had complications grade 3 or higher and one patient died (1.9%). Tumor pathology was adenocarcinoma in 39 patients. A complete resection was achieved in 97%. Twenty nine patients (74%) with gastric adenocarcinoma had early gastric cancer and 84% of patients were in stage one. Median lymph node count was 24. Median follow-up was 26 (1-91) months. There was no cancer related mortality among patients subjected to a curative resection. Overall survival for patients with adenocarcinoma was 92% at 3 years. Conclusions: This study supports the feasibility and safety of a laparoscopic gastrectomy program in a public hospital; with low morbidity, adequate lymph node dissection and long-term survival. This approach must be considered an option for selected patients with gastric cancer.