title: Laparoscopic total gastrectomy with D2 lymph node dissection for gastric cancer.
abstract: 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.
authors.affiliation: Department of Surgery, Fujita Health University School of Medicine, Kutsukakecho, Toyoake, Aichi 470-1192, Japan. shinohara@jikei.ac.jp
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Shinohara
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Kanaya
authors.forename: Keizo
authors.initials: K
authors.lastname: Taniguchi
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Fujita
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
authors.forename: Ichiro
authors.initials: I
authors.lastname: Uyama
mesh_terms: 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