Evaluation of Laparoscopic Approach in Gastric Cancer Surgery: A Single-Center Observational Study

Öz

Objective: This study aimed to evaluate the feasibility of laparoscopic surgery in gastric cancer and to compare its oncological effectiveness and perioperative outcomes with open surgery. Materials and Methods: A total of 54 patients who underwent surgery for gastric cancer between June 2020 and June 2025 at Istanbul Aydın University Faculty of Medicine, Department of General Surgery, were retrospectively analyzed. Surgical approach, number of retrieved and metastatic lymph nodes, preoperative radiological and postoperative pathological tumor sizes, operative times, complications, and hospital stay were assessed. Results: The mean age was 62.4 ± 12.7 years, and 72.2% were male. Laparoscopic surgery was completed in 74% of cases. No significant difference was found between laparoscopic and open surgery regarding the number of retrieved and metastatic lymph nodes (p>0.05). Operative time was significantly shorter in the laparoscopic group compared to the open group (163.3 min vs. 196.8 min; p=0.0037). Postoperative pathological tumor size was significantly larger compared to preoperative radiological measurements (p=0.0216). In patients receiving neoadjuvant chemotherapy, tumor shrinkage was observed but not statistically significant (p=0.1047). The perioperative complication rate was 24%, anastomotic leakage rate 5.5%, and mortality rate 1.8%. Conclusion: Laparoscopic surgery is a safe and feasible approach for gastric cancer, providing comparable oncological outcomes to open surgery while offering shorter operative times. Although neoadjuvant therapy contributes to tumor regression, its statistical impact on tumor size reduction should be validated in larger cohorts.

Anahtar Kelimeler

• Gastric cancer
• laparoscopic surgery
• neoadjuvant chemotherapy
• complications
• tumor size

Mide Kanseri Cerrahisinde Laparoskopik Yaklaşımın Değerlendirilmesi: Tek Merkezli Bir Gözlemsel Çalışma

Öz

Amaç: Bu çalışmada mide kanseri cerrahisinde laparoskopik yaklaşımın uygulanabilirliği ve açık cerrahi ile karşılaştırıldığında onkolojik etkinliği ile perioperatif sonuçları değerlendirilmiştir. Gereç ve Yöntem: Haziran 2020 – Haziran 2025 tarihleri arasında İstanbul Aydın Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniği’nde mide kanseri nedeniyle opere edilen 54 hasta retrospektif olarak incelendi. Cerrahi yöntem, çıkarılan ve metastatik lenf nodu sayıları, preoperatif radyolojik ve postoperatif patolojik tümör boyutları, ameliyat süreleri, komplikasyonlar ve yatış süreleri analiz edildi. Bulgular: Hastaların yaş ortalaması 62,4 ± 12,7 yıl olup %72,2’si erkekti. Cerrahilerin %74’ü laparoskopik olarak tamamlandı. Laparoskopik ve açık cerrahi arasında çıkarılan toplam ve metastatik lenf nodu sayıları açısından anlamlı fark yoktu (p>0,05). Laparoskopik cerrahilerin ortalama süresi açık cerrahiden anlamlı derecede kısa bulundu (163,3 dk vs. 196,8 dk; p=0,0037). Preoperatif ve postoperatif tümör boyutları karşılaştırıldığında, postoperatif ölçümler daha yüksek bulundu ve fark anlamlıydı (p=0,0216). Neoadjuvan kemoterapi alan hastalarda tümör boyutunda küçülme eğilimi izlense de anlamlı değildi (p=0,1047). Perioperatif komplikasyon oranı %24, anastomoz kaçağı oranı %5,5, mortalite oranı ise %1,8 olarak saptandı. Sonuç: Laparoskopik cerrahi mide kanseri tedavisinde güvenle uygulanabilir ve açık cerrahiye benzer onkolojik sonuçlar sunar. Neoadjuvan tedavi tümör regresyonuna katkı sağlasa da tümör boyutundaki değişikliklerin anlamlılığı daha geniş serilerde doğrulanmalıdır.

Anahtar Kelimeler

• Mide kanseri
• laparoskopik cerrahi
• neoadjuvan kemoterapi
• komplikasyon
• tümör boyutu

Kaynakça

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