title: Laparoscopy-assisted and open distal gastrectomies for early gastric cancer at a general hospital in Japan.
abstract: OBJECTIVE
  At general hospitals in Japan, laparoscopic surgery for early gastric cancer is not yet popular. The benefits and feasibility of this procedure remain to be established. The aim of this study was to evaluate the surgical outcome of laparoscopy-assisted distal gastrectomy (LADG) in comparison with open distal gastrectomy (ODG) in a general hospital.
  
  
  METHODS
  We performed LADG in 20 patients with early gastric cancer between 2000 and 2001. Clinicopathologic data, blood analyses, clinical course and financial cost of treating patients with LADG were compared with 22 patients treated with ODG between 1998 and 1999.
  
  
  RESULTS
  All patients were treated successfully by LADG. Neither reduced operative curability nor increased complications were found with this procedure. Although LADG required a significantly longer operation time than ODG, blood loss was lower in LADG than in ODG. The leukocyte count on day 1 and day 3, and serum C-reactive protein levels on day 1 were significantly lower after LADG than after ODG. There was no significant difference between LADG and ODG in the period and volume of analgesics required. High body temperature continued longer after ODG than after LADG. The first walking, passage of flatus and oral diet initiation were significantly earlier in patients with LADG than in those with ODG. LADG required a significantly shorter hospital stay and less total hospital charge than ODG.
  
  
  CONCLUSIONS
  Laparoscopy-assisted distal gastrectomy offered faster recovery of gastrointestinal function, a shorter hospital stay, and consequently less financial cost when compared with open surgery. Therefore, LADG may be a safe and recommendable procedure for patients with early gastric cancer at general hospitals in Japan.
authors.affiliation: Department of Surgery, Tottori Red Cross Hospital, Tottori, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Naka
authors.forename: Takanori
authors.initials: T
authors.lastname: Ishikura
authors.forename: Syunsuke
authors.initials: S
authors.lastname: Shibata
authors.forename: Yumi
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Minoru
authors.initials: M
authors.lastname: Ishiguro
authors.forename: Eiichi
authors.initials: E
authors.lastname: Yurugi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nishidoi
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kudoh
authors.forename: Satoshi
authors.initials: S
authors.lastname: Murakami
authors.forename: Shunichi
authors.initials: S
authors.lastname: Tsujitani
mesh_terms: D016063:Blood Loss, Surgical; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000191:economics / Q000379:methods*; D017722:Hospital Charges; D006769:Hospitals, General; D006801:Humans; D007564:Japan; D010535:Laparoscopy / Q000191:economics; D007902:Length of Stay; D008297:Male; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome