title: Gasless laparoscopy-assisted distal gastrectomy is feasible and useful for non-obese patients with early gastric cancer.
abstract: OBJECTIVE
  To evaluate the feasibility and usefulness of gasless laparoscopy-assisted distal gastrectomy except when treating obese patients compared with open distal gastrectomy for early cancer.
  
  
  METHODS
  We treated 92 patients with distal gastrectomy for early gastric cancer consecutively. Patients with massive submucosal invasion and/or LN swelling were allocated for the open method, and patients with slightly invasive submucosal cancer were allocated for gasless laparoscopy-assisted surgery. As exceptions we employed open surgery for overweight patients and gasless laparoscopy for elderly and/or feeble patients.
  
  
  RESULTS
  We attempted to perform open and laparoscopy-assisted surgery on 52 and 40 patients, respectively. Three cases in the laparoscopy-assisted group were converted to open surgery because of obesity. The age was older and BMI was lower in the laparoscopy-assisted group. In terms of operative time and blood loss as well as postoperative recovery, the results for the laparoscopy-assisted group were superior to those of the open surgery group. There were no cases of cardiopulmonary complications for the laparoscopy-assisted group.
  
  
  CONCLUSIONS
  Gasless laparoscopy-assisted distal gastrectomy is feasible and useful for early gastric cancer except when treating obese patients.
authors.affiliation: Department of Surgery, Jichi Medical School, Minami-Kawachi, Tochigi 329-0498, Japan. mhyodo@jichi.ac.jp
authors.forename: Masanobu
authors.initials: M
authors.lastname: Hyodo
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hosoya
authors.forename: Kentarou
authors.initials: K
authors.lastname: Kurashina
authors.forename: Shin
authors.initials: S
authors.lastname: Saitoh
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Hirashima
authors.forename: Taku
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Wataru
authors.initials: W
authors.lastname: Arai
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yasuda
authors.forename: Hideo
authors.initials: H
authors.lastname: Nagai
authors.forename: Chuuji
authors.initials: C
authors.lastname: Sekiguchi
mesh_terms: D000368:Aged; D015992:Body Mass Index; D005240:Feasibility Studies; D005260:Female; D005740:Gases; D005753:Gastric Mucosa / Q000473:pathology; D005763:Gastroenterostomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000473:pathology; D013274:Stomach Neoplasms / Q000601:surgery* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D005740:Gases