title: Comparison of early outcomes of intracorporeal and extracorporeal gastroduodenostomy after laparoscopic distal gastrectomy for gastric cancer.
abstract: BACKGROUND
  Totally laparoscopic distal gastrectomy (TLDG) has several advantages over laparoscopic-assisted distal gastrectomy (LADG), including a shorter incision, less pain, and earlier recovery. We compared the feasibility and early surgical outcomes of TLDG and LADG in patients with gastric cancer.
  
  
  METHODS
  Between September 2008 and December 2009, 180 patients with gastric cancer underwent TLDG with intracorporeal gastroduodenostomy using linear staplers; and between January 2006 and December 2009, 268 patients with gastric cancer underwent LADG with extracorporeal gastroduodenostomy using circular staplers. Clinical features and early surgical outcomes were compared between the two groups.
  
  
  RESULTS
  There were no between-group differences in postoperative clinical course and complications. Postoperative pain and the amount of pain killer administered were significantly lower (P<.05 each), and postoperative scars were smaller in the TLDG group.
  
  
  CONCLUSIONS
  TLDG with intracorporeal gastroduodenostomy is as safe and feasible as LADG for patients with gastric cancer. Moreover, TLDG is less invasive and more comfortable for patients than LADG.
authors.affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. bskim@amc.seoul.kr
authors.forename: Beom Su
authors.initials: BS
authors.lastname: Kim
authors.forename: Jeong Hwan
authors.initials: JH
authors.lastname: Yook
authors.forename: Youn Baik
authors.initials: YB
authors.lastname: Choi
authors.forename: Kab Choong
authors.initials: KC
authors.lastname: Kim
authors.forename: Min Gyu
authors.initials: MG
authors.lastname: Kim
authors.forename: Tae Hwan
authors.initials: TH
authors.lastname: Kim
authors.forename: Hironori
authors.initials: H
authors.lastname: Kawada
authors.forename: Byung Sik
authors.initials: BS
authors.lastname: Kim
mesh_terms: D004385:Duodenostomy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005763:Gastroenterostomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome