title: Laparoscopic total gastrectomy for remnant gastric cancer: feasibility study.
abstract: BACKGROUND
  The benefits and feasibility of laparoscopic surgery for remnant gastric cancer are still unclear. The purpose of this study was to describe the detailed procedure and to evaluate the clinical short-term outcomes of laparoscopic total gastrectomy (LTG) compared with open total gastrectomy (OTG) for remnant gastric cancer (RGC).
  
  
  METHODS
  Of 1,247 consecutive patients who underwent gastrectomy for gastric cancer in our department at Kyushu University Hospital from January 1996 to May 2012, 22 patients who underwent successful curative resection of RGC with precise nodal dissection were enrolled in this study. Twelve patients underwent LTG and the remaining ten patients underwent OTG. We analyzed the clinical short-term outcomes of LTG and compared the results between LTG and OTG groups to evaluate the safety and feasibility of LTG.
  
  
  RESULTS
  Twelve patients with RGC successfully underwent LTG without open conversion and morbidity. The mean operation time of LTG, 362.3 ± 68.4 min, was significantly longer than that of OTG (p = 0.0176), but the mean blood loss of LTG, 65.8 ± 62 g, was smaller than that of OTG (p < 0.01). The mean postoperative times to resumption of water and food intake were significantly shorter in the LTG group than in the OTG group (p < 0.01). The overall 3-year survival rate was comparable between the LTG and OTG groups (77.8 vs. 100 %; p = 0.9406).
  
  
  CONCLUSIONS
  This study shows that LTG is a feasible and reliable procedure for the treatment of RGC in terms of short-term outcomes.
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan, eishi@surg1.med.kyushu-u.ac.jp.
authors.forename: Eishi
authors.initials: E
authors.lastname: Nagai
authors.forename: Kohei
authors.initials: K
authors.lastname: Nakata
authors.forename: Kenoki
authors.initials: K
authors.lastname: Ohuchida
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyasaka
authors.forename: Shuji
authors.initials: S
authors.lastname: Shimizu
authors.forename: Masao
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000556:secondary; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D018530:Gastric Stump; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000556:secondary; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome