title: Clinical Significance of Totally Laparoscopic Distal Gastrectomy: A Comparison of Short-term Outcomes Relative to Open and Laparoscopic-assisted Distal Gastrectomy.
abstract: BACKGROUND
  Laparoscopic distal gastrectomy has become an established minimally invasive treatment for gastric cancer since it was first reported in 1994.
  
  
  METHODS
  We retrospectively assessed the clinical outcomes of 248 patients who had undergone open distal gastrectomy (ODG), laparoscopic-assisted distal gastrectomy (LADG), and totally laparoscopic distal gastrectomy (TLDG) for gastric cancer.
  
  
  CONCLUSIONS
  TLDG showed superiority in terms of blood loss, reconstruction options, and postoperative recovery compared with ODG and LADG. Especially, the mean operating time in the TLDG group was significantly shorter than that of the LADG group (P=0.003). Book-binding technique used in TLDG was one of the reasons of this result. The only inferior aspect of TLDG was the longer operating time compared with ODG; TLDG had no disadvantages compared with LADG. Although the operating time and long-term outcome remain problems, we suggest that TLDG has the potential to serve as an optimal operative method.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Sho
authors.initials: S
authors.lastname: Nishimura
authors.forename: Eiji
authors.initials: E
authors.lastname: Oki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tsutsumi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Tsuda
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sugiyama
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Nakashima
authors.forename: Hideto
authors.initials: H
authors.lastname: Sonoda
authors.forename: Kippei
authors.initials: K
authors.lastname: Ohgaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saeki
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D016063:Blood Loss, Surgical; D004435:Eating; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome