Hand-assisted laparoscopic total gastrectomy with regional lymph node dissection for advanced gastric cancer.
OBJECTIVE
Laparoscopic-assisted distal gastrectomy has been applied to the treatment of gastric cancer. However, there have been few reports on the laparoscopic-assisted total gastrectomy for advanced gastric cancer, mainly because of the difficulty of the procedure.


METHODS
Here, we report a series of cases where the hand-assisted laparoscopic total gastrectomies with regional lymph node dissection were performed successfully.


RESULTS
The average operative time was 245 minutes. The mean blood loss was 110 mL. The number of dissected lymph nodes per patient was beyond 15 nodes satisfying a reliable evaluation of nodal status. All resection specimens had no residual tumor at the proximal or distal resection margins. The mean oral feeding was 3.6 days. The mean postoperative length of stay was 8.7 days.


CONCLUSIONS
The hand-assisted laparoscopic D2 total gastrectomy for advanced gastric cancer is both technically feasible and safe.
Department of General Surgery, Henan Provincial People's Hospital, Zhengzhou, China.
Guang-tan
GT
Zhang
Yu-cheng
YC
Song
Xue-dong
XD
Zhang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D058733:Hand-Assisted Laparoscopy / Q000379:methods*; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome