The Role of Laparoscopy in Distal Gastric Cancer

Abstract

Since the first successful laparoscopic cholecystectomy, this type of approach has progressively extended its applications to gastric cancer. The aim of our study is to review available data to determine the role of laparoscopy in gastric cancer.

Results. Laparoscopy was used as a preoperative staging tool or approach for the radical and palliative surgical procedures. Laparoscopy is superior to CT, when it comes to detect the gastric wall’s serous invasion, namely the T3 stage. It has also been proven to be the most useful method of diagnosing some occult metastases. Applied routinely, prior to the resection that might become radical, it has allowed the pre-surgical staging to be corrected by 23,5% - 44%. The radical resections are possible through laparoscopic approach by observing the oncological principles with advantages of minimal invasion. The most frequent indications are represented by early gastric cancer and T2 for T3, the experience being limited. The laparoscopic approach also offers a negative impact, more reduced on the natural evolution of the neoplastic disease.

Conclusions. Laparoscopic approach has progressively expanded its indications to preoperative staging of gastric cancer, completing the data obtained by other diagnostic means, and to radical resections in both early and advanced stages, bringing the benefits of lesser invasion with faster postoperative recovery and less influence on the cancer’s natural history, at the same time observing the oncological surgery principles.