Long Term Survival and Quality of Life after Minimally Invasive Surgery for Early Gastric Cancer

Minimally invasive surgery (MIS) was used for early gastric cancer, and the long-term survival and quality of life (QOL) were evaluated according to the method of surgery. Mucosal gastric carcinoma (m-carcinoma) without an ulcer and/or scar was an indication for MIS, because our previous study showed that there was no lymph node metastasis of m-carcinoma less than 2.5cm in the cohort of the resected 1, 000 early gastric cancer cases. MISs included endoscopic mucosal resection (EMR), laparoscopic surgery (LAP) and modified radical gastrectomy (D1 + #7 operation). Differentiated adenocarcinoma less than 1cm was an indication for ERM, the elevated type less than 2.5cm and the depressed type less than 1.5cm were resected by LAP, and the other m-carcinomas without ulcer and/or scar were treated by the D1 + #7 operation. LAP consisted of the lesion-lifting method for the lesions in the anterior wall and intragastric mucosal resection for the lesions in the posterior wall. The postoperative survival of the treted patients was almost the same as that after the standard radical gastrectomy (D2 operation), and their postoperative QOL was found to be better than that after the D2 operation. These MISs were thought to be appropriate in improving the postopertive QOL without the loss of survival benefit.