title: Relevance of totally laparoscopic gastrectomy for patients with advanced gastric cancer.
abstract: OBJECTIVE
  Although the use of laparoscopic gastrectomy for gastric cancer has been widespread, it has remained controversial whether it can be applied for the patients with advanced gastric cancer. The aim of this study was to clarify the safety and usefulness of totally laparoscopic gastrectomy for patients with advanced gastric cancer.
  
  
  METHODS
  Totally laparoscopic gastrectomy was applied for a total of 38 patients with pStage IB-III advanced gastric cancer at our institute. The surgical and long-term results were analyzed in those patients.
  
  
  RESULTS
  Twenty-seven patents underwent distal gastrectomy and 11 patients underwent total gastrectomy. The mean number of dissected lymph nodes was 41 (range, 16-87). The mean length of the operation and amount of blood loss was 324 min and 123 ml, respectively. Two cases of postoperative bleeding were noted, while neither anastomosis-related complications nor in-hospital death was observed. The follow-up period after surgery was 8-72 months. Postoperative recurrence was observed in 6 patients (peritoneal dissemination: 3 patients, pleural dissemination: 1 patient, liver metastasis: 1 patient, ovarian metastasis: 1 patient). The overall survival rates at 1, 3 and 5 years were 94.7%, 76.3% and 76.3%, respectively.
  
  
  CONCLUSIONS
  Totally laparoscopic gastrectomy is safe and can lead to satisfactory long-term outcomes in cases of advanced gastric cancer. Prospective controlled studies are warranted to confirm our findings.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saeki
authors.forename: Eiji
authors.initials: E
authors.lastname: Oki
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Tsuda
authors.forename: Koji
authors.initials: K
authors.lastname: Ando
authors.forename: Yukiharu
authors.initials: Y
authors.lastname: Hiyoshi
authors.forename: Shuhei
authors.initials: S
authors.lastname: Itoh
authors.forename: Masaru
authors.initials: M
authors.lastname: Morita
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ikeda
authors.forename: Keishi
authors.initials: K
authors.lastname: Sugimachi
authors.forename: Yo-Ichi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Toru
authors.initials: T
authors.lastname: Ikegami
authors.forename: Hideaki
authors.initials: H
authors.lastname: Uchiyama
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Soejima
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kawanaka
authors.forename: Koshi
authors.initials: K
authors.lastname: Mimori
authors.forename: Masayuki
authors.initials: M
authors.lastname: Watanabe
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors