title: Totally laparoscopic distal gastrectomy with D2 lymphadenectomy and Billroth II gastrojejunostomy for gastric cancer: short- and medium-term results of 139 consecutive cases from a single institution.
abstract: OBJECTIVE
  The goal of this study was to investigate the feasibility, safety, and associated 3-year survival outcomes of the totally laparoscopic distal gastrectomy (TLDG) for the treatment of gastric cancer.
  
  
  METHODS
  Herein, we analyzed the clinical data from 139 consecutive patients with gastric cancer who received TLDG at our institution from March of 2007 to March of 2013.
  
  
  RESULTS
  TLDG was successfully carried out in 139 patients; no cases were converted to open surgery. The mean operation time was 228.6 ± 51.0 minutes, mean blood loss was 131.2 ± 85.2 mL, and mean number of dissected lymph nodes was 31.1 ± 9.0. The average time to flatus, time to fluid diet, and length of hospital stay were 3.6 ± 1.1 days, 4.8 ± 1.6 days, and 9.8 ± 4.0 days, respectively. The postoperative morbidity was 10.1%. A total of 135 patients were followed for a subsequent 1-73 months (median, 24.0 months). The 3-year disease-free survival (DFS) and overall survival (OS) rates were 82.3% and 82.9%, respectively. When divided by stage, the 3-year DFS for stage I, II, and III were 100%, 86.2%, and 48.8%, respectively; and the 3-year OS for stage I, II, and III were 98.0%, 92.3%, and 51.6%, respectively.
  
  
  CONCLUSIONS
  In this preliminary report, TLDG was found to be a safe, feasible, and efficacious procedure for the treatment of gastric cancer with encouraging 3-year overall and stage-by-stage survival rates.
authors.affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Institute of Micro-invasive Surgery, Zhejiang University, Hangzhou, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Chen
authors.forename: Xiaowu
authors.initials: X
authors.lastname: Xu
authors.forename: Yiping
authors.initials: Y
authors.lastname: Mou
authors.forename: Yu
authors.initials: Y
authors.lastname: Pan
authors.forename: Renchao
authors.initials: R
authors.lastname: Zhang
authors.forename: Yucheng
authors.initials: Y
authors.lastname: Zhou
authors.forename: Di
authors.initials: D
authors.lastname: Wu
authors.forename: Chaojie
authors.initials: C
authors.lastname: Huang
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005763:Gastroenterostomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*
keywords: clinical study; gastric cancer; laparoscopy; survival
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