title: A systematic review of laparoscopic total gastrectomy for gastric cancer.
abstract: BACKGROUND
  Laparoscopic total gastrectomy (LTG) has been performed since 1999. Although surgical outcomes have been reported from Japan, Korea, China, and many Western countries, the effectiveness of this technique has not been conclusively established. This study therefore aimed to review the literature systematically.
  
  
  METHODS
  Our search of the research literature identified 150 studies, which were mostly retrospective and from single institutions.
  
  
  RESULTS
  There has recently been a remarkable increase in the number of studies from Korea, and the number of patients included in studies has increased since 2009. In most studies, the surgical procedures were longer, blood loss was reduced, and the number of retrieved lymph nodes was the same in the LTG group as in the open total gastrectomy group. The incidence of postoperative complications and that of inflammation during postoperative recovery were the same in these two groups.
  
  
  CONCLUSIONS
  During LTG, the method used for esophagojejunostomy is important for surgical reliability and to reduce postoperative complications. There has been rapid development of new techniques from the level of esophagojejunostomy through a small skin incision to the high level of intracorporeal esophagojejunostomy using various techniques. A nationwide prospective phase II study is urgently needed to establish the value of LTG.
authors: Department of Surgery, Gastroenterological Center, Yokohama City University, 4-57, Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan, s0714@med.yokohama-cu.ac.jp.
authors: Chikara
authors: C
authors: Kunisaki
authors: Hirochika
authors: H
authors: Makino
authors: Ryo
authors: R
authors: Takagawa
authors: Jun
authors: J
authors: Kimura
authors: Mitsuyoshi
authors: M
authors: Ota
authors: Yasushi
authors: Y
authors: Ichikawa
authors: Takashi
authors: T
authors: Kosaka
authors: Hirotoshi
authors: H
authors: Akiyama
authors: Itaru
authors: I
authors: Endo
mesh_terms: D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D011379:Prognosis; D013274:Stomach Neoplasms / Q000601:surgery*