Feasibility of laparoscopic gastrectomy for advanced gastric cancer with positive peritoneal cytology

Purpose The role of gastrectomy for patients with positive peritoneal cytology, but a negative macroscopic peritoneal implant (P−/cy+), remains unclear. The aim of this study was to evaluate laparoscopic gastrectomy for P−/cy+ patients. Methods This study reviewed a prospectively maintained gastric cancer database of gastric-cancer patients those underwent surgical resection. P−/cy+ gastric cancer that had invaded the subserosa, or deeper layers, of the stomach wall without distant organ metastases was considered operable in this institution. P−/cy+ patients underwent either open or laparoscopic gastrectomy with D2 lymphadenectomy. The short-term results were examined to assess differences in outcome between the two groups. Results Eighteen P−/cy+ patients without distant organ metastases underwent surgery between 2000 and 2010. Laparoscopic gastrectomy was performed in nine patients and open gastrectomy in nine patients. The estimated blood loss was significantly smaller, the resumption of food intake earlier, and the length of postoperative hospital stay shorter in the patients that underwent laparoscopic gastrectomy than in the patients that underwent open gastrectomy. There were no significant differences in the 2-year survival rates between the groups. Conclusion Laparoscopic gastrectomy for P−/cy+ patients is a minimally invasive and safe oncologic procedure with good short-term results.