title: Comparison of short-term outcomes and acute inflammatory response between laparoscopy-assisted and totally laparoscopic distal gastrectomy for early gastric cancer.
abstract: OBJECTIVE
  Laparoscopic gastrectomy is widely used to treat early gastric cancer. The advantages of totally laparoscopic distal gastrectomy (TLDG) are unproven, and some concerns remain regarding the early surgical outcomes due to its technical difficulty. We compared the early surgical outcomes and acute inflammatory response between patients undergoing TLDG and laparoscopy-assisted distal gastrectomy (LADG) for treatment of early gastric cancer.
  
  
  METHODS
  We performed a retrospective study on 212 consecutive patients who underwent laparoscopic distal gastrectomy for gastric cancer between January 2008 and June 2014. A total of 179 LADG cases and 33 TLDG cases were included. After age, sex, body mass index, and American Society of Anesthesiologists physical status score were matched using propensity score matching (PSM), we compared the short-term surgical outcomes between the LADG and TLDG groups.
  
  
  RESULTS
  The TLDG group had a shorter hospital stay (9.5 days vs. 11.0 days, P = 0.046) and less blood loss (116.6 mL vs. 141.5 mL, P = 0.031) than those in the LADG group. There were no differences in the preoperative WBC count and CRP level and the other clinical data between the two groups after PSM. Postoperative WBC count, serum CRP level, and decrease rate of WBC count in the TLDG group were significantly lower than those in the LADG group.
  
  
  CONCLUSIONS
  The short-term outcomes of TLDG revealed better than that of LADG in this study. Therefore, TLDG is one of the safe and feasible procedure for the treatment of early gastric cancer.
authors.affiliation: Department of Surgery, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Surgery, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: In-Hwan
authors.initials: IH
authors.lastname: Kim
authors.affiliation: Department of Medical Statistics, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Sang-Gyu
authors.initials: SG
authors.lastname: Kwak
authors.affiliation: Department of Surgery, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Hyun-Dong
authors.initials: HD
authors.lastname: Chae
keywords: Acute-phase reaction; Laparoscopy; Propensity score; Short-term outcome; Stomach neoplams