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Operative time was longer with laparoscopic surgery, while blood loss and hospital stay were significantly lower; morbidity and survival endpoints were comparable.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/short-and-long-term-outcomes-after-laparoscopic-versus-open-total-gastrectomy-for-advanced-gastric-cancer/460823/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/short-and-long-term-outcomes-after-laparoscopic-versus-open-total-gastrectomy-for-advanced-gastric-cancer/460823.png","ImageObject",300,407,{"name":42,"@type":43},"Jacob","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-05","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What was the study objective for advanced gastric cancer patients?","Question",{"text":63,"@type":64},"To compare the short- and long-term outcomes of laparoscopic total gastrectomy versus open total gastrectomy in advanced gastric cancer.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How were patients selected and how was bias reduced?",{"text":68,"@type":64},"Consecutive patients undergoing LTG or OTG with lymph node dissection from January 2002 to June 2024 were included, and propensity score matching was performed at a 1:1 ratio.",{"name":70,"@type":61,"acceptedAnswer":71},"What were the key perioperative differences between LTG and OTG?",{"text":72,"@type":64},"LTG had a longer median operative time but significantly less blood loss and a shorter median hospital stay, with comparable postoperative morbidity.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},460823,1790814578,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & 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Gastrectomy for Advanced Gastric Cancer  \nYOSHIHIKO KAWAGUCHI, KATSUTOSHISHODA, SUGURU MARUYAMA, RYO SAITO, WATARU IZUMO, KOICHI TAKIGUCHI, KENSUKE SHIRAISHI, SHINJI FURUYA, HIDETAKE AMEMIYA, HIROMICHI KAWAIDA and DAISUKE ICHIKAWA  \nFirst Department of Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Japan  \nAbstract  \nBackground/Aim: Total gastrectomyisthe cornerstone treatment for gastric cancer, particularly inpatients with proximalor large tumors. For early-stage gastric cancer, laparoscopic total gastrectomy (LTG) has demonstrated comparable short-and long-term outcomes to those of open total gastrectomy (OTG), while reportson advanced gastric cancer (AGC) are limited. We aimed to compare the short-and long-term outcomes of patients with AGC who underwent LTG or OTG. Patients and Methods: This study included consecutive patients with AGC who underwent LTG or OTG with lymph node dissection at our institution from January 2002 to June 2024. Propensity score matching was conducted ata 1:1 ratio to reduce bias.  \nResults: A total of 158 patients were enrolled (LTG: 39; OTG: 119) . Of these, 64 were paired by propensity score matching. The clinical tumor invasion depth was balanced, but the pathological depth was significantly deeper in the LTG group. The number of patients with lymph node metastasis did not differ. The median operative time was longer for LTG (512.5 min) than for OTG (267 min), whereas LTG resulted in significantly less blood loss (125 g vs. 411 g) . Postoperative morbidity (≥Clavien‒Dindo grade 3) was comparable (LTG: 12.5%, OTG: 9.4%) . The LTG group had a significantly shorter median hospital stay (11 days vs. 17 days) . There were no significant differences in overall or recurrence-free survival between the groups.  \nConclusion: LTG is a feasible and safe approach forAGC, offering comparable short-and long-term outcomes to OTG.  \nKeywords: Laparoscopy, open surgery, total gastrectomy, gastric cancer, advanced cancer.  \nIntroduction  \nGastric cancer remains a significant global health problem and is the fifth leading cause of cancer morbidity and  \nrelated mortality worldwide. Despite the development of various new drugs to treat gastric cancer, surgical curative resection remains the mainstay of treatment. Open distal gastrectomy (ODG) is the standard of care for patients with  \n✉ Daisuke Ichikawa, First Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo,  \nYamanashi 4093898, Japan. Tel: +81 552737390, Fax: +81 552737390, [e-mail: dichikawa@yamanashi.ac.jp](e-mail: dichikawa@yamanashi.ac.jp)  \nReceived September 28, 2025 | Revised October 17, 2025 | Accepted October 20, 2025  \nThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \n©2026 The Author(s) . Anticancer Research is published by the International Institute of Anticancer Research.  \ngastric cancer worldwide (1). However, since the first case of laparoscopic distal gastrectomy (LDG) was reported in 1994 (2), and with continuous improvements made in laparoscopic hemostatic devices and surgical techniques, it has become widely used worldwide. Ina large populationbased study, researchers reported shorter hospital stays after laparoscopic gastrectomy, comparable or decreased postoperative complications, and comparable lymph node dissection (3-5) . Furthermore, the results of various randomized controlled trials (RCTs) [JCOG0912 (6, 7), KLASS01 (8, 9)] have shown comparable short-term and long-term results of LDG and ODG for early-stage gastric cancer, and LDG has become a standard surgical procedure. Furthermore, the results of RCTs on the short-term and long-term outcomes of LDG and ODG for advanced gastric cancer (AGC) have been reported in Japan (10, 11), Korea (","cbCaikkKmdE80hFF","https://ap.wps.com/l/cbCaikkKmdE80hFF","pdf",661743,14,"English","# Abstract\n## Background/Aim\n## Patients and Methods\n## Results\n## Conclusion\n# Introduction\n# Patients and Methods","[{\"question\":\"What was the study objective for advanced gastric cancer patients?\",\"answer\":\"To compare the short- and long-term outcomes of laparoscopic total gastrectomy versus open total gastrectomy in advanced gastric cancer.\"},{\"question\":\"How were patients selected and how was bias reduced?\",\"answer\":\"Consecutive patients undergoing LTG or OTG with lymph node dissection from January 2002 to June 2024 were included, and propensity score matching was performed at a 1:1 ratio.\"},{\"question\":\"What were the key perioperative differences between LTG and OTG?\",\"answer\":\"LTG had a longer median operative time but significantly less blood loss and a shorter median hospital stay, with comparable postoperative morbidity.\"}]","Short-and Long-term Outcomes After Laparoscopic Versus Open Total Gastrectomy for Advanced Gastric Cancer | PDF",1790759730,35]