Laparoscopic total gastrectomy with D2 lymph node dissection for gastric cancer.
OBJECTIVE
To evaluate the safety and effectiveness of laparoscopic total gastrectomy with D2 lymphadenectomy for gastric cancer.


METHODS
Review of findings from a prospectively acquired institutional database.


METHODS
University hospital.


METHODS
Fifty-five consecutive patients operated on by the same surgeon between October 1997 and March 2008.


METHODS
Blood loss, complication rate, and survival.


RESULTS
All operations were accomplished without conversion to open laparotomy. The median operative time was 406 minutes. The median blood loss was 102 mL. A median of 46 lymph nodes were harvested. The TNM stages of the tumor were I in 17 patients (31%), II in 12 (22%), III in 16 (29%), and IV in 10 (18%). A total of 21 complications occurred in 18 patients (33%) with no postoperative mortality. At last follow-up, 44 of the 55 patients were alive without tumor recurrence and 3 with recurrence at a median follow-up of 16 months, whereas 8 had died of recurrence or another cause.


CONCLUSIONS
The mortality rate of zero and acceptable morbidity of our series indicate that laparoscopic total gastrectomy with D2 lymphadenectomy is technically feasible and safe in the hands of experienced surgeons. Long-term follow-up is mandatory to validate oncologic outcome.
Shinohara
Toshihiko
T
Department of Surgery, Fujita Health University School of Medicine, Kutsukakecho, Toyoake, Aichi 470-1192, Japan. shinohara@jikei.ac.jp
Kanaya
Seiichiro
S
Taniguchi
Keizo
K
Fujita
Tetsuji
T
Yanaga
Katsuhiko
K
Uyama
Ichiro
I
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013156:Splenectomy; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome