title: Video-assisted surgery in gastric cancer.
abstract: BACKGROUND
  The present study presents the initial results of the use of video-assisted surgery in the curative intent treatment of gastric cancer in a specialised unit of esophago-gastric pathology.
  
  
  METHODS
  Since December 2002 we have substituted laparotomy for video-assisted surgery for the surgical treatment of gastric cancer. We report our initial experience in 28 patients. In 20 we performed a total gastrectomy with Roux Y esophago-jejunum reconstruction. In another 8 cases we performed subtotal gastrectomy with Roux Y reconstruction. The anastomoses in total gastrectomy were performed with laparoscopy with the EEA head descending via the endo-esophageal route. The resected piece is extracted via minimum laparotomy. The associated complete lympadenectomy D2 was performed in the tumours of the gastric antrum and D1 plus the lymph node groups 7, 8, 9 and proximal 11 at the second level in the gastric body and fundus.
  
  
  RESULTS
  The mean duration of intervention was 222 minutes and the mean blood loss was 185 ml. Mortality was 3.7% and morbidity was 19%. There was a reduction in post-operative analgesia requirements and the mean hospital stay was 11 days.
  
  
  CONCLUSIONS
  Gastric resection and related lympadenectomy can be performed using video-assisted surgery in a manner that is as safe as conventional surgery and, further, has considerable advantages. The greater complexity requires that the surgical team is better trained in the use of the laparoscopy technique. In the few studies on the theme, there appears to be no oncological inconveniences associated with the technique.
authors.affiliation: Unidad de Cirugía Esofagogástrica, Servicio de Cirugía General y Digestiva, Hospital Universitario de Girona Dr. Josep Trueta, Girona, Spain. jroigg@tiscali.es
authors.forename: Josep
authors.initials: J
authors.lastname: Roig
authors.forename: Jordi
authors.initials: J
authors.lastname: Gironès
authors.forename: Elisenda
authors.initials: E
authors.lastname: Garsot
authors.forename: Manel
authors.initials: M
authors.lastname: Puig
authors.forename: Marcel
authors.initials: M
authors.lastname: Pujades
authors.forename: José I
authors.initials: JI
authors.lastname: Rodríguez
authors.forename: Antoni
authors.initials: A
authors.lastname: Codina
mesh_terms: D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D013274:Stomach Neoplasms / Q000601:surgery*; D020535:Video-Assisted Surgery