Experience of distal gastrectomy by minilaparotomy with laparoscopic-assistance for nonoverweight patients with T1N0-1 gastric cancer.
To evaluate the usefulness of laparoscopic assistance for curative distal gastrectomy by minilaparotomy, 19 patients (body mass index < or = 25.0 kg/m2) with T1NO-1 gastric cancer who underwent distal gastrectomy with a minilaparotomy (skin incision < or = 7 cm) with laparoscopic assistance (LA (+) group) were compared with 19 historic controls who underwent equivalent surgery by minilaparotomy without laparoscopic assistance (LA (--) group). The percentage of patients with blood loss more than 300 mL tended to be lower in the LA (+) group (5.3% versus 31.6%, P = 0.09). The first flatus passage was earlier (P = 0.04), serum C-reactive protein levels on postoperative day 1 were lower (P = 0.04), and white blood cell counts on postoperative day 1 tended to be lower (P = 0.07) in the LA (+) group. Minilaparotomy with laparoscopic assistance seems to be less invasive compared with pure minilaparotomy. This procedure is considered to be a simple alternative to standard laparoscopic-assisted distal gastrectomy in selected patients with T1NO-1 gastric cancer.
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan. 05hishi@saitama-med.ac.jp
Hideyuki
H
Ishida
Toru
T
Ishiguro
Norimichi
N
Okada
Kensuke
K
Kumamoto
Keiichiro
K
Ishibashi
Tatsuya
T
Miyazaki
Norihiro
N
Haga
D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery*
D002097:C-Reactive Protein