Bien Hoa

Gastric cancer is a significant health concern worldwide, and surgical removal of the stomach and lymph nodes is the primary treatment option. This research compares the outcomes of laparoscopic total gastrectomy LTG with open total gastrectomy OTG in patients who have locally advanced gastric cancer stages cT2-4a. The trial aims to provide evidence on the technical feasibility, safety, and oncological results of LTG compared to the traditional open surgery. The study involves two surgical approaches LTG, which uses small incisions and specialized instruments to remove the stomach and lymph nodes with a laparoscopic method, and OTG, which involves a larger incision in the abdomen for open surgery. Both approaches include D2 lymph node dissection and reconstruction using the Roux-en-Y method. The LTG procedure requires five trocars and detailed dissection along specific blood vessels and lymph node groups. OTG uses a 15 to 20 cm abdominal incision for the standard total gastrectomy and lymphadenectomy. The trial compares these methods in terms of surgical technique and outcomes. Participants will be evaluated on several measures including 3-year overall survival and relapse-free survival after surgery. Secondary outcomes include operative morbidity and mortality within 30 days, operative time, number of lymph nodes removed, and hospital stay length. The study will monitor patients closely during and after surgery to assess these outcomes. The total participation period includes long-term follow-up to understand survival and cancer recurrence over three years after surgery.