title: Laparoscopic gastrectomy in patients with previous gastrectomy for gastric cancer: a report of 17 cases.
abstract: BACKGROUND
  Laparoscopic gastrectomy (LAG) is increasingly used as a treatment for gastric cancer. However, it is contraindicated in patients with previous abdominal surgery, because of a higher risk of enteric injury, technical difficulties associated with adhesions, and longer operative times. The aim of this study was to assess the feasibility and clinical outcomes of LAG in patients who had previously undergone gastrectomy for gastric cancer.
  
  
  METHODS
  Between June 2008 and May 2012, we performed laparoscopic gastrectomies in 17 patients with remnant stomach cancer who had previously undergone open gastrectomy (10 patients) or LAG (7 patients) for early gastric cancer. We performed laparoscopic distal gastrectomies with Roux-en-Y gastrojejunostomy in 10 patients, and laparoscopic total gastrectomies in 7 patients.
  
  
  RESULTS
  None of the patients required conversion to open surgery or intraoperative transfusion. One patient with postoperative bleeding received a transfusion of 4 U of blood. There were 2 cases of serious postoperative complications: 1 internal herniation and 1 anastomosis leakage. One patient experienced tractitis at the trocar site. All patients had tumor-free resection margins, and there were no mortalities.
  
  
  CONCLUSIONS
  LAG is a safe and realistic treatment for patients who have previously undergone gastrectomy, although it may be associated with an increased need for adhesiolysis and longer surgery times.
authors.affiliation: Department of Gastric Surgery, Asan Medical Center, Ulsan University School of Medicine, Seoul, Korea.
authors.forename: Hee Sung
authors.initials: HS
authors.lastname: Kim
authors.forename: Beom Su
authors.initials: BS
authors.lastname: Kim
authors.forename: In Seob
authors.initials: IS
authors.lastname: Lee
authors.forename: Sol
authors.initials: S
authors.lastname: Lee
authors.forename: Jeoung Hwan
authors.initials: JH
authors.lastname: Yook
authors.forename: Byung Sik
authors.initials: BS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods; D015390:Gastric Bypass; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome