A comparison between two methods for tumor localization during totally laparoscopic distal gastrectomy in patients with gastric cancer.
OBJECTIVE
The aim of this study was to compare two methods of tumor localization during totally laparoscopic distal gastrectomy (TLDG) in patients with gastric cancer.


METHODS
From March 2014 to November 2014, patients in whom TLDG had been engaged for middle third gastric cancer enrolled in this study. The patients were allocated to either the radiography or endoscopy group based on the type of tumor localization technique. Clinicopathologic outcomes were compared between the 2 groups.


RESULTS
The accrual was suspended in November 2014 when 39 patients had been enrolled because a failed localization happened in the radiography group. The radiography and endoscopy groups included 17 (43.6 %) and 22 patients (56.4 %), respectively. Mean length of the proximal resection margin did not differ between the radiography and endoscopy groups (4.0 ± 2.6 and 2.8 ± 1.2 cm, respectively; P = 0.077). Mean localization time was longer in the radiography group than in the endoscopy group (22.7 ± 11.4 and 6.9 ± 1.8 minutes, respectively, P < 0.001). There were no statistically significant differences in the incidence of severe complications between the 2 groups (5.9% and 4.5%, respectively, P = 0.851).


CONCLUSIONS
As an intraoperative tumor localization for TLDG, radiologic method was unsafe even though other comparable parameters were not different from that of endoscopy group. Moreover, intraoperative endoscopic localization may be advantageous because it is highly accurate and contributes to reducing operation time.
Department of Surgery, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
Chang Min
CM
Lee
Department of Surgery, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
Sungsoo
S
Park
Department of Surgery, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
Seong-Heum
SH
Park
Department of Surgery, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
You Jin
YJ
Jang
Department of Surgery, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
Seung-Joo
SJ
Kim
Department of Surgery, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
Young-Jae
YJ
Mok
Department of Surgery, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
Chong-Suk
CS
Kim
Department of Surgery, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
Jong-Han
JH
Kim
Endoscopy; Gastrectomy; Laparoscopy; Stomach neoplasms