Laparoscopic Versus Open Surgery in Cancer: New Studies Add Data to Debate

Extract

A new study comparing the safety and efficacy of open surgery to minimally invasive laparoscopic surgery for gastric cancer showed that patients had similar rates of recurrence-free survival at 3 years. But there were statistically significant reductions in pain and late complications among patients who had laparoscopy and a trend toward more early complications in open surgery.

Most important, with laparoscopy, surgeons removed not only all the cancer but also a median of 18 lymph nodes, according to Vivian Strong, M.D., lead author and assistant attending surgeon at Memorial Sloan–Kettering Cancer Center in New York. This finding addressed one of the many questions that still surround minimally invasive surgery (MIS): whether it is possible to remove enough lymph nodes to accurately stage the cancer.

Strong's study, published in April in the Annals of Surgical Oncology , is one of many comparing outcomes of minimally invasive and open surgery for lung, kidney, esophageal, bladder, prostate, and colorectal cancer. The data are welcome, say experts who worry that although MIS is clearly on the rise, few studies have weighed outcomes.