City of Hope surgeons have shown that laparoscopic surgery for stomach cancer is as effective as standard open surgery, but with fewer complications and quicker recovery.

The study, the largest of its kind in North America, was published online May 15 in the Annals of Surgical Oncology.

Joshua D.I. Ellenhorn (Photo by Darrin S. Joy)

A team of clinical researchers led by Joshua D.I. Ellenhorn, M.D., associate professor and chief of the Division of General Oncologic Surgery, looked at the records of 78 patients who underwent surgery to remove stomach cancer. Of those, 30 patients underwent laparoscopic surgery and 48 had open surgery.

While open surgery uses one large incision, laparoscopic surgery uses specialized instruments and video cameras that enter the body through several small incisions. The minimally invasive method aims to lessen blood loss and other complications related to surgery, reduce pain after surgery and hasten recovery.

According to Ellenhorn, laparoscopic surgery is not as well-accepted in the U.S. and Canada as open surgery for stomach cancer removal.

“It’s a technically demanding procedure, and it can take longer than open methods,” he said. Surgeons also worry that removal of lymph nodes, called lymphadenectomy, may be less effective with laparoscopic surgery, he added.

Surgeons remove the lymph nodes surrounding a tumor to check them for cancer cells. The presence of tumor cells in a lymph node can mean the cancer has begun to spread and needs more aggressive treatment.

“One of the key points we make in the study is that we can do lymphadenectomy just as well with laparoscopic surgery — both robotic-assisted and standard laparoscopic — as we can with open surgery,” said Ellenhorn. Proving that should give other surgeons confidence in the minimally invasive procedure and lead to wider use of the method.

Ellenhorn would like to see laparoscopic surgery adopted as the standard for stomach cancer.

“The potential benefit in reduced suffering and recovery time for patients is well worth the added difficulty of the procedure,” he said.

City of Hope surgeons use both standard laparoscopic and robotic-assisted techniques to perform minimally invasive gastric cancer surgeries.

Co-authors included Eduardo A. Guzman, M.D., Alessio Pigazzi, M.D., Ph.D., Byrne Lee, M.D., Perry A. Soriano, M.D., Rebecca A. Nelson, Ph.D., I. Benjamin Paz, M.D., Vijay Trisal, M.D., and Joseph Kim, M.D.