[Totally laparoscopic gastrectomy for gastric cancer].
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.
Xu
Xiao-wu
XW
Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China.
Mou
Yi-ping
YP
Yan
Jia-fei
JF
Yan
Huan-jun
HJ
Xu
Bin
B
Chen
Qi-long
QL
Wang
Song-biao
SB
Zhou
Yu-cheng
YC
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