title: Laparoscopic-assisted total gastrectomy for adenocarcinoma in a western country: safety and oncological issues.
abstract: BACKGROUND
  Laparoscopic total gastrectomy for adenocarcinoma is a widely diffused operation in eastern countries, but there are only a few reports from western centers. We assessed a single surgeon's experience at a single, nonacademic, community hospital.
  
  
  METHODS
  Short-term outcome of patients undergoing laparoscopic total gastrectomy for adenocarcinoma (June 2005-March 2010) was assessed.
  
  
  RESULTS
  Fourteen patients (5 males, 9 females; median age, 66.8 years [interquartile range, 59.7-71.8]) underwent laparoscopic total gastrectomy. The median operative time was 240 min. There were five stage 1 patients, five stage 2, and four stage 3; R0 resection was obtained in all 14 patients, and the median number of lymph nodes retrieved was 38. Mortality and overall morbidity rates were 0% and 35.7%, respectively.
  
  
  CONCLUSIONS
  The outcomes of laparoscopic total gastrectomy for adenocarcinoma performed by a well-trained laparoscopic surgeon working in a community hospital are good in terms of safety for the patients and response to the oncological criteria used in open surgery.
authors.affiliation: Department of General Surgery, Azienda ULSS 15 Alta Padovana, Cittadella (Padua), Italy. valentino.fiscon@virgilio.it
authors.forename: Valentino
authors.initials: V
authors.lastname: Fiscon
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Portale
authors.forename: Giovanni
authors.initials: G
authors.lastname: Migliorini
authors.forename: Flavio
authors.initials: F
authors.lastname: Frigo
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000193:education / Q000295:instrumentation / Q000379:methods*; D006764:Hospitals, Community; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000009:adverse effects* / Q000193:education / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome