Laparoscopy-assisted pylorus-preserving gastrectomy: a matched case-control study.
BACKGROUND
Pylorus-preserving gastrectomy (PPG) has been widely accepted as the standard treatment for early gastric cancer, and the laparoscopic approach has been gradually introduced. The aim of this study is to investigate the short-term outcome of laparoscopy-assisted PPG (LAPPG) in comparison with open PPG (OPPG).


METHODS
Between April 2006 and May 2009, a cohort of 418 patients with early gastric cancer in the middle third of the stomach underwent PPG, and 90 of the LAPPG patients and 90 of the OPPG patients among them were matched for sex, age, and body mass index. The outcomes of the patients in the two groups were then compared.


RESULTS
Operation time was significantly longer in the LAPPG group than in the OPPG group (270 vs. 195 min, P < 0.001), and there was significantly less blood loss in the LAPPG group than in the OPPG group (29 vs. 97 ml, P < 0.001). The overall incidence of surgery-related complications in the two groups was similar (8.9 vs. 11.1%). The proportion of patients who used analgesics after postoperative day 5 was significantly lower in the LAPPG group than in the OPPG group (35.6 vs. 61.1%, P = 0.001). There was no significant difference between the two groups in the interval between surgery and resumption of oral feeding, the interval between surgery and first flatus, number of patients with body temperature of 38°C or more, or length of hospital stay.


CONCLUSIONS
LAPPG can be performed safely in terms of short-term outcome.
Gastric Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Norimitsu
N
Tanaka
Hitoshi
H
Katai
Makoto
M
Saka
Shinji
S
Morita
Takeo
T
Fukagawa
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D005334:Fever / Q000453:epidemiology; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D011183:Postoperative Complications / Q000453:epidemiology; D011708:Pylorus; D020127:Recovery of Function; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
D000700:Analgesics