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In Costa Rica, many patients diagnosed with advanced gastric cancer face the need for major surgery as part of their treatment. A common question is whether laparoscopic surgery (a less invasive approach using small incisions) is as safe as the traditional open operation. A recent study published in JAMA Surgery provides clear, evidence-based guidance to help patients understand their options.
The study evaluated two surgical approaches for T4a gastric cancer, a stage in which the tumor reaches the outer layer of the stomach. It compared laparoscopic distal gastrectomy with open distal gastrectomy, both performed with a complete D2 lymph node dissection, which is the standard for curative treatment.
Results showed that both surgeries had nearly identical rates of complications and 30-day mortality. Although the laparoscopic procedure required more operative time and slightly more blood loss, these differences did not translate into added risk. Infection rates, respiratory issues, abdominal complications, and the need for reoperation were similar between groups. Recovery milestones (tolerating food, passing gas, and leaving the hospital) were also comparable.
Importantly, laparoscopic surgery achieved the same oncologic quality as open surgery: clear surgical margins, an adequate number of lymph nodes removed, and low rates of residual disease. This means that, when performed by experienced surgeons, the minimally invasive approach does not compromise curative intent.
For patients in Costa Rica, these findings offer reassurance. In specialized centers with trained teams and standardized protocols, laparoscopic surgery can be a safe and effective option, offering a more comfortable recovery without decreasing the quality of cancer treatment. Radiation Oncology remains an important part of care when additional control is needed, but this study confirms that minimally invasive surgery can fit safely within a modern, comprehensive treatment plan.
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