Laparoscopy-assisted total gastrectomy for early gastric cancer: comparison with conventional open total gastrectomy.
Laparoscopy-assisted distal gastrectomy has been applied to the treatment of early gastric cancer in Japan. So far, several studies about comparison between laparoscopy-assisted distal gastrectomy and conventional open distal gastrectomy were reported. However, there are few reports on the laparoscopy-assisted total gastrectomy, mainly because this procedure is performed relatively infrequently, and the procedure is more difficult than laparoscopy-assisted distal gastrectomy. This was a case-control study comparing between laparoscopy-assisted total gastrectomy group and open total gastrectomy group. From June 2001 to August 2004, laparoscopy-assisted total gastrectomy was performed in 20 patients. Reconstruction was performed by Roux-en-Y method or Roux-en-Y with jejunal pouch method through the mini-laparotomy. These cases were compared with 19 cases of open total gastrectomy, regarding operating time, blood loss, leukocyte count, C-reactive protein, time to the first passage of gas, time to initiate oral intake, and postoperative hospital stay.Laparoscopy-assisted total gastrectomy was successful in 20 patients. The mean operating time was 280 minutes and blood loss was 227.5 mL. Leukocyte counts on days 1, 3, and 7 were significantly lower in laparoscopic surgery group than in open surgery group. The time to first flatus, time to initiate oral intake, and postoperative hospital stay was significantly shorter (P < 0.05) in the laparoscopic surgery group than in the open surgery group. This study demonstrated that laparoscopy-assisted total gastrectomy is suitable and feasible for early gastric cancer and has the advantage of a shorter recovery time compared with open total gastrectomy.
Usui
Shinsuke
S
Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan. cdd40470@hkg.odn.ne.jp
Yoshida
Tatsuya
T
Ito
Koji
K
Hiranuma
Susumu
S
Kudo
Shin-Ei
SE
Iwai
Takehisa
T
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome