Article

Comparison of laparoscopic and open gastrectomy on cancer cells exfoliating from the cancer-invaded serosa.

Department of General Surgery and Center of Minimal Invasive Gastrointestinal Surgery, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China.
Surgical laparoscopy, endoscopy & percutaneous techniques (impact factor: 1.23). 07/2009; 19(3):201-7. DOI:10.1097/SLE.0b013e3181a75957 pp.201-7
Source: PubMed

ABSTRACT Whether laparoscopic gastrectomy may reduce the frequency of gastric cancer cells exfoliating from the cancer-invaded serosa remains unclear. This study aimed to compare the detection of free gastric cancer cells in the peritoneal cavity during laparoscopic and open gastrectomy.
Intraoperative peritoneal washings were collected from 63 gastric cancer patients undergoing laparoscopic gastrectomy and 61 patients undergoing open surgery. Hematoxylin and eosin staining and real time reverse transcription-polymerase chain reaction were used to examine the free cancer cells.
The postoperative positive rates of free cancer cells detected by cytologic and real time reverse transcription-polymerase chain reaction were 39.68% and 44.26% in the laparoscopic and open groups, respectively. The depth of tumor invasion, area of invaded serosa, regional lymph node involvement, and higher tumor node metastasis staging were significantly associated with the presence of free cancer cells.
The laparoscopic techniques used in gastric cancer surgery were not associated with a greater risk for the intraperitoneal dissemination of cancer cells than conventional techniques.

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Keywords

61 patients undergoing open surgery
 
63 gastric cancer patients undergoing laparoscopic gastrectomy
 
cancer cells
 
cancer-invaded serosa
 
conventional techniques
 
eosin staining
 
free cancer cells
 
free gastric cancer cells
 
gastric cancer cells exfoliating
 
gastric cancer surgery
 
greater risk
 
Intraoperative peritoneal washings
 
intraperitoneal dissemination
 
laparoscopic gastrectomy
 
laparoscopic techniques
 
open gastrectomy
 
open groups
 
postoperative positive rates
 
regional lymph node involvement
 
tumor invasion
 

Ying-Xue Hao