title: Technical feasibility and safety of laparoscopy-assisted total gastrectomy in gastric cancer: a comparative study with laparoscopy-assisted distal gastrectomy.
abstract: OBJECTIVE
  Only a few surgeons with much experience of laparoscopic surgery perform laparoscopy-assisted total gastrectomy (LATG), because of its technical difficulty and concern about subsequent complications. The aim of this study was to evaluate the technical feasibility and safety of LATG as compared with laparoscopy-assisted distal gastrectomy (LADG) in gastric cancer.
  
  
  METHODS
  From January 2002 to December 2007, LADG was performed in 473 patients and LATG in 67 patients at the Korean National Cancer Center. Surgical procedures and short-term surgical outcomes of LATG were analyzed.
  
  
  RESULTS
  D2 lymph node dissection was performed in 35 LATG (52.2%) cases and in 274 LADG (57.9%) cases (P = 0.378). Mean blood losses during operation were 156.8 +/- 158.0 ml and 190.7 +/- 176.2 ml, respectively (P = 0.114). The open conversion rate for LATG was higher than LADG without significance (4.3% vs. 1.7%, P = 0.153). Complications occurred in 18 LATG cases (26.9%) and 38 LADG cases (8.0%) (P < 0.001). The most common postoperative complication of LATG was anastomotic stricture after esophagojejunostomy.
  
  
  CONCLUSIONS
  LATG is a technically feasible procedure as compared with LADG. However, its postoperative complication rate is higher than that of LADG, especially that of anastomotic stricture. A more effective anastomotic method during LATG is required to prevent stricture.
authors: Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Gyeonggi-do, South Korea.
authors: Sang Eok
authors: SE
authors: Lee
authors: Keun Won
authors: KW
authors: Ryu
authors: Byung Ho
authors: BH
authors: Nam
authors: Jun Ho
authors: JH
authors: Lee
authors: Young-Woo
authors: YW
authors: Kim
authors: Jun Sik
authors: JS
authors: Yu
authors: Soo Jeong
authors: SJ
authors: Cho
authors: Jong Yeul
authors: JY
authors: Lee
authors: Chan Gyoo
authors: CG
authors: Kim
authors: Il Ju
authors: IJ
authors: Choi
authors: Myeong Cherl
authors: MC
authors: Kook
authors: Sook Ryun
authors: SR
authors: Park
authors: Min Ju
authors: MJ
authors: Kim
authors: Jong Seok
authors: JS
authors: Lee
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D016063:Blood Loss, Surgical; D004940:Esophageal Stenosis / Q000209:etiology; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*