Length of Hospital Stay With Laparoscopic vs Open Gastrectomy for Gastric Cancer
- 3 years ago
In the Dutch LOGICA trial reported in the Journal of Clinical Oncology, van der Veen et al found that laparoscopic gastrectomy was not associated with shorter hospital stay vs open gastrectomy in patients with gastric cancer.
Study Details
In the trial, conducted at 10 sites in the Netherlands, 227 patients with resectable (cT1–4aN0–3bM0) gastric adenocarcinoma were randomly assigned between 2015 and 2018 to undergo laparoscopic (n = 115) or open gastrectomy (n = 112). Neoadjuvant chemotherapy was administered to 77 patients (67%) in the laparoscopic group and 87 patients (78%) in the open surgery group. The primary outcome was length of hospital stay. All analyses were performed in the intent-to-treat population, except as specified below.
KEY POINTS
Median hospital stay was 8 days vs 8 days among 48 vs 43 patients undergoing total gastrectomy and 6 days vs 6 days among 59 vs 64 patients undergoing distal gastrectomy.
Postoperative complications occurred in 44% vs 42% of patients, with anastomotic leakage occurring in 9% vs 10%.
Hospital Stay and Other Outcomes
Median hospital stay was 7 days (interquartile range [IQR] = 5–9 days) in both the laparoscopic and open surgery groups (probability of shorter stay with laparoscopic approach = .54, P = .34). Mean hospital stay was 9.5 days vs 9.2 days (P = .83). No significant difference in hospital stay between 106 vs 105 patients in the per-protocol population was observed (mean difference = 0.7, 95% confidence interval [CI] = -2 to 3.4 days).
Median hospital stay was 8 days vs 8 days among 48 vs 43 patients undergoing total gastrectomy (P = .82) and 6 days vs 6 days among 59 vs 64 patients undergoing distal gastrectomy (P = .60).
The laparoscopic group had significantly less median blood loss (150 vs 300 mL, P
Study Details
In the trial, conducted at 10 sites in the Netherlands, 227 patients with resectable (cT1–4aN0–3bM0) gastric adenocarcinoma were randomly assigned between 2015 and 2018 to undergo laparoscopic (n = 115) or open gastrectomy (n = 112). Neoadjuvant chemotherapy was administered to 77 patients (67%) in the laparoscopic group and 87 patients (78%) in the open surgery group. The primary outcome was length of hospital stay. All analyses were performed in the intent-to-treat population, except as specified below.
KEY POINTS
Median hospital stay was 8 days vs 8 days among 48 vs 43 patients undergoing total gastrectomy and 6 days vs 6 days among 59 vs 64 patients undergoing distal gastrectomy.
Postoperative complications occurred in 44% vs 42% of patients, with anastomotic leakage occurring in 9% vs 10%.
Hospital Stay and Other Outcomes
Median hospital stay was 7 days (interquartile range [IQR] = 5–9 days) in both the laparoscopic and open surgery groups (probability of shorter stay with laparoscopic approach = .54, P = .34). Mean hospital stay was 9.5 days vs 9.2 days (P = .83). No significant difference in hospital stay between 106 vs 105 patients in the per-protocol population was observed (mean difference = 0.7, 95% confidence interval [CI] = -2 to 3.4 days).
Median hospital stay was 8 days vs 8 days among 48 vs 43 patients undergoing total gastrectomy (P = .82) and 6 days vs 6 days among 59 vs 64 patients undergoing distal gastrectomy (P = .60).
The laparoscopic group had significantly less median blood loss (150 vs 300 mL, P