Laparoscopically assisted total gastrectomy with lymph node dissection for upper and middle gastric cancer.
BACKGROUND
In recent years, laparoscopic gastrectomy has been applied for the treatment of gastric cancer in Japan and Western countries. This report describes the short- and long-term results for patients with gastric cancer who underwent laparoscopically assisted total gastrectomy (LATG) with lymph node dissection.


METHODS
From September 1999 to December 2007, 20 patients underwent LATG, and 18 underwent conventional open total gastrectomy (OTG) for upper and middle gastric cancer. The indications for LATG included depth of tumor invasion limited to the mucosa or submucosa and absence of lymph node metastases in preoperative examinations. The LATG and OTG procedures for gastric cancer were compared in terms of pathologic findings, operative outcome, complications, and survival.


RESULTS
No significant difference was found between LATG and OTG in terms of operation time (254 vs 248 min.), number of lymph nodes (26 vs 35), complication rate (25% vs 17%), or 5-year cumulative survival rate (95% vs 90.9%). Differences between LATG and OTG were found with regard to blood loss (299 vs 758 g) and postoperative hospitalization (19 vs 29 days).


CONCLUSIONS
For properly selected patients, laparoscopically assisted total gastrectomy can be a curative and minimally invasive treatment for early gastric cancer.
Mochiki
Erito
E
Department of General Surgical Science, Faculty of Medicine, Gunma University, Maebashi, Japan. emochiki@showa.gunma-u.ac.jp
Toyomasu
Yoshitaka
Y
Ogata
Kyouichi
K
Andoh
Hiroyuki
H
Ohno
Tetsuro
T
Aihara
Ryusuke
R
Asao
Takayuki
T
Kuwano
Hiroyuki
H
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D016063:Blood Loss, Surgical; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy; D007902:Length of Stay; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis