title: Comparison of short-term postoperative outcomes in totally laparoscopic distal gastrectomy versus laparoscopy-assisted distal gastrectomy.
abstract: OBJECTIVE
  The advantages of totally laparoscopic surgery in early gastric cancer (EGC) are unproven, and some concerns remain regarding the oncologic safety and technical difficulty. This study aimed to evaluate the technical feasibility and clinical benefits of totally laparoscopic distal gastrectomy (TLDG) for the treatment of gastric cancer compared with laparoscopy-assisted distal gastrectomy (LADG).
  
  
  METHODS
  A retrospective review of 211 patients who underwent either TLDG (n=134; 63.5%) or LADG (n=77; 36.5%) for EGC between April 2005 and October 2013 was performed. Clinicopathologic features and surgical outcomes were analyzed and compared between the groups.
  
  
  RESULTS
  The operative time in the TLDG group was significantly shorter than that in the LADG group (193 [range, 160~230] vs. 215 minutes [range, 170~255]) (P=0.021). The amount of blood loss during TLDG was estimated at 200 ml (range, 100~350 ml), which was significantly less than that during LADG, which was estimated at 400 ml (range, 400~700 ml) (P<0.001). The hospital stay in the TLDG group was shorter than that in the LADG group (7 vs. 8 days, P<0.001). One patient from each group underwent laparotomic conversion. Two patients in the TLDG group required reoperation: one for hemostasis after intraabdominal bleeding and 1 for repair of wound dehiscence at the umbilical port site.
  
  
  CONCLUSIONS
  TLDG for distal EGC is a technically feasible and safe procedure when performed by a surgeon with sufficient experience in laparoscopic gastrectomy and might provide the benefits of reduced operating time and intraoperative blood lossand shorter convalescence compared with LADG.
authors: Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors: Gru
authors: G
authors: Han
authors: Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors: Ji Yeon
authors: JY
authors: Park
authors: Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors: Yong Jin
authors: YJ
authors: Kim
keywords: Gastrectomy; Laparoscopy; Stomach neoplasms