J Korean Surg Soc.  2011 Apr;80(4):245-250. 10.4174/jkss.2011.80.4.245.

The effects of laparoscopic assisted total gastrectomy on surgical outcomes in the treatment of gastric cancer

Affiliations
  • 1Division of Gastric Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. bskim@amc.seoul.kr

Abstract

PURPOSE
To evaluate the effectiveness of laparoscopic assisted total gastrectomy (LATG), we compared its early surgical outcomes with those of conventional open total gastrectomy (OTG) in patients who were diagnosed as having early gastric cancer preoperatively.
METHODS
We retrospectively analyzed early surgical outcomes in 190 consecutive patients who underwent total gastrectomy for early gastric cancer between January 2009 to April 2010. The patients were divided into those who underwent LATG and those who underwent OTG. Their early surgical outcomes were analyzed to evaluate the effectiveness of LATG.
RESULTS
There was no significant difference in postoperative complication rates (P = 0.291). But in the analysis of other early surgical outcomes, we found that LATG could improve time to first flatus (P < 0.001), time to commencement of soft diet (P = 0.034), administration of analgesics (P = 0.024), pain score (Numeric Rating Scale), and hospital discharge (P = 0.045).
CONCLUSION
Although LATG didn't show better results for postoperative complications than those of OTG, LATG contributes to the improvement of early surgical outcomes, including bowel movement, pain score and hospital discharge. Therefore, we suggest that LATG could be a method to improve early surgical outcomes in patients who need total gastrectomy.

Keyword

Early gastric cancer; Laparoscopic assisted total gastrectomy; Open total gastrectomy

MeSH Terms

Analgesics
Diet
Flatulence
Gastrectomy
Humans
Postoperative Complications
Retrospective Studies
Stomach Neoplasms
Analgesics

Figure

  • Fig. 1 Trocar placement for laparoscopic assisted total gastrectomy. Op, operator; F.A, first assistant; Sc, scopist; S.N, Scrub nurse; 5 mm, 5 mm port; 12 mm, 12 mm port.

  • Fig. 2 Rolling up the straight needle in the abdomen.


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