title: [Totally laparoscopic gastrectomy for gastric cancer].
abstract: OBJECTIVE
  To evaluate the feasibility and clinical efficacy of totally laparoscopic gastrectomy (TLG) for gastric cancer.
  
  
  METHODS
  The investigators retrospectively analyzed 37 cases undergoing TLG for gastric cancer from March 2007 to April 2009 at Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University.
  
  
  RESULTS
  All 37 cases underwent successful TLG. There was neither transfer to open nor laparoscopic assisted surgery. Twenty-nine cases underwent distal gastrectomy with Billroth II reconstruction, 8 cases total gastrectomy with Roux-en-Y reconstruction, including 5 cases with end-to-side esophageal jejunostomy and 3 cases with side-to-side esophageal jejunostomy. Nineteen cases assisted by intraoperative gastroscopy for tumor locating. The operation duration was 210 - 355 min [mean (284 +/- 43) min]. The blood loss was 80 - 450 ml [mean (175 +/- 62) ml]. The number of dissected lymph nodes was 18 - 55 [mean (31 +/- 9)]. Two cases had post-operative complications, with 1 case of pulmonary infection recovering well after symptomatic treatment and 1 case of temporary delayed gastric emptying recovering well after gastrointestinal decompression for 6 days. No mortality was reported. The hospital stay was 6 - 14 d [mean (9 +/- 2) d]. There was no recurrence during the follow-up period of 2 - 25 months.
  
  
  CONCLUSIONS
  For surgeons with rich experiences of laparoscopic surgery, TLG for gastric cancer is both safe and feasible. The short-term efficacy of TLG is satisfactory. Furthermore, TLG conforms more to the concept of minimally invasive surgery and the principle of tumor-free technique.
authors.affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China.
authors.forename: Xiao-wu
authors.initials: XW
authors.lastname: Xu
authors.forename: Yi-ping
authors.initials: YP
authors.lastname: Mou
authors.forename: Jia-fei
authors.initials: JF
authors.lastname: Yan
authors.forename: Huan-jun
authors.initials: HJ
authors.lastname: Yan
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
authors.forename: Qi-long
authors.initials: QL
authors.lastname: Chen
authors.forename: Song-biao
authors.initials: SB
authors.lastname: Wang
authors.forename: Yu-cheng
authors.initials: YC
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome