title: Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancer.
abstract: BACKGROUND
  Laparoscopy-assisted surgery with extraperigastric lymph node dissection for gastric cancers has been described, but the clinical benefits of these surgeries still are unclear. Short-term clinical outcomes were compared between laparoscopy-assisted distal gastrectomy (LADG) and conventional open distal gastrectomy (ODG) for early gastric cancer in a prospective randomized fashion.
  
  
  METHODS
  For this study, 28 patients with early gastric cancers in the lower half of the stomach were randomly assigned to either LADG (n = 4) or ODG (n = 14). Postoperative pain, levels of acute inflammatory responses, and pathologic evaluation of the operative specimens were compared.
  
  
  RESULTS
  The LADG group required a significantly shorter period of postoperative epidural anesthesia, showed significantly lower levels of serum interleukin-6 and C-reactive protein, and had no major postsurgery complications. Pathologic examinations showed that surgery was equally radical in the two groups.
  
  
  CONCLUSIONS
  The findings show that LADG with extraperigastric lymph node dissection is a safe and less invasive alternative to the open procedure.
authors.affiliation: Research Center for Frontier Medical Engineering, 1-33, Yayoi-cho, Inage-ku, Chiba, 263-8522, Japan. hhayashi@faculty.chiba-u.jp
authors.forename: H
authors.initials: H
authors.lastname: Hayashi
authors.forename: T
authors.initials: T
authors.lastname: Ochiai
authors.forename: H
authors.initials: H
authors.lastname: Shimada
authors.forename: Y
authors.initials: Y
authors.lastname: Gunji
mesh_terms: D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*