J Gastric Cancer.  2013 Mar;13(1):44-50.

Comparison of Laparoscopy-Assisted and Totally Laparoscopic Distal Gastrectomy: The Short-Term Outcome at a Low Volume Center

Affiliations
  • 1Department of Surgery, National Medical Center, Seoul, Korea. jmparkgs@gmail.com

Abstract

PURPOSE
Laparoscopic gastrectomy has been adopted for the treatment of gastric cancer, and despite the technical difficulties, totally laparoscopic distal gastrectomy has been considered less invasive than laparoscopy-assisted distal gastrectomy. Although there have been many reports regarding the feasibility and safety of totally laparoscopic distal gastrectomy at large volume centers, few reports have been conducted at low-volume centers. The purpose of this study is to try to assess the feasibility and safety of totally laparoscopic distal gastrectomy at a low volume center through the analysis of short-term outcomes of totally laparoscopic distal gastrectomy compared with laparoscopy-assisted distal gastrectomy.
MATERIALS AND METHODS
The clinical data and short-term surgical outcomes of 35 patients who had undergone laparoscopy-assisted distal gastrectomy between April 2007 and March 2010, and 37 patients who underwent totally laparoscopic distal gastrectomy between April 2010 and August 2012 were retrospectively reviewed.
RESULTS
There was no significant difference in the demographic and clinical data. However the reconstruction method and extent of lymphadenectomy showed statistically significant differences. Operation time and estimated blood loss did not show significant differences. Surgical and medical complications did not show significant differences but postoperative courses including time-to-first oral intake and postoperative hospital stay were significantly increased.
CONCLUSIONS
Our study shows that totally laparoscopic distal gastrectomy is technically feasible at a low volume center. Therefore, totally laparoscopic distal gastrectomy can be considered as one of the surgical treatment for early gastric cancer. However the possibility that totally laparoscopic distal gastrectomy may have less benefit should also be considered.

Keyword

Stomach neoplasms; Laparoscopy; Gastrectomy

MeSH Terms

Gastrectomy
Humans
Laparoscopy
Length of Stay
Lymph Node Excision
Retrospective Studies
Stomach Neoplasms

Reference

1. Jung KW, Park S, Won YJ, Kong HJ, Lee JY, Park EC, et al. Prediction of cancer incidence and mortality in Korea, 2011. Cancer Res Treat. 2011. 43:12–18.
Article
2. Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N. Japanese Laparoscopic Surgery Study Group. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007. 245:68–72.
Article
3. Ikeda O, Sakaguchi Y, Aoki Y, Harimoto N, Taomoto J, Masuda T, et al. Advantages of totally laparoscopic distal gastrectomy over laparoscopically assisted distal gastrectomy for gastric cancer. Surg Endosc. 2009. 23:2374–2379.
Article
4. Song KY, Park CH, Kang HC, Kim JJ, Park SM, Jun KH, et al. Is totally laparoscopic gastrectomy less invasive than laparoscopy-assisted gastrectomy?: prospective, multicenter study. J Gastrointest Surg. 2008. 12:1015–1021.
Article
5. Kim KH, Kim MC, Jung GJ, Kim HH. Long-term outcomes and feasibility with laparoscopy-assisted gastrectomy for gastric cancer. J Gastric Cancer. 2012. 12:18–25.
Article
6. Lee J, Kim D, Kim W. Comparison of laparoscopy-assisted and totally laparoscopic Billroth-II distal gastrectomy for gastric cancer. J Korean Surg Soc. 2012. 82:135–142.
Article
7. Kinoshita T, Shibasaki H, Oshiro T, Ooshiro M, Okazumi S, Katoh R. Comparison of laparoscopy-assisted and total laparoscopic Billroth-I gastrectomy for gastric cancer: a report of short-term outcomes. Surg Endosc. 2011. 25:1395–1401.
Article
8. Choi YY, Bae J, Hur KY, Choi D, Kim YJ. Reinforcing the staple line during laparoscopic sleeve gastrectomy: does it have advantages? A meta-analysis. Obes Surg. 2012. 22:1206–1213.
Article
9. Kim M, Park J, Kim SG, Choi S, Yoon S, Lee S. Feasibility of gastric cancer surgery at low volume hospitals. J Gastric Cancer. 2010. 10:234–240.
Article
10. Jin SH, Kim DY, Kim H, Jeong IH, Kim MW, Cho YK, et al. Multidimensional learning curve in laparoscopy-assisted gastrectomy for early gastric cancer. Surg Endosc. 2007. 21:28–33.
Article
11. Kim MC, Jung GJ, Kim HH. Learning curve of laparoscopy-assisted distal gastrectomy with systemic lymphadenectomy for early gastric cancer. World J Gastroenterol. 2005. 11:7508–7511.
Article
12. Kim JJ, Song KY, Chin HM, Kim W, Jeon HM, Park CH, et al. Totally laparoscopic gastrectomy with various types of intracorporeal anastomosis using laparoscopic linear staplers: preliminary experience. Surg Endosc. 2008. 22:436–442.
Article
13. Lee SI, Choi YS, Park DJ, Kim HH, Yang HK, Kim MC. Comparative study of laparoscopy-assisted distal gastrectomy and open distal gastrectomy. J Am Coll Surg. 2006. 202:874–880.
Article
14. Hayashi H, Ochiai T, Shimada H, Gunji Y. Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancer. Surg Endosc. 2005. 19:1172–1176.
Article
15. Lee JH, Han HS, Lee JH. A prospective randomized study comparing open vs laparoscopy-assisted distal gastrectomy in early gastric cancer: early results. Surg Endosc. 2005. 19:168–173.
Article
16. Kim HI, Hyung WJ, Lee CR, Lim JS, An JY, Cheong JH, et al. Intraoperative portable abdominal radiograph for tumor localization: a simple and accurate method for laparoscopic gastrectomy. Surg Endosc. 2011. 25:958–963.
Article
17. Hyung WJ, Lim JS, Cheong JH, Kim J, Choi SH, Song SY, et al. Intraoperative tumor localization using laparoscopic ultrasonography in laparoscopic-assisted gastrectomy. Surg Endosc. 2005. 19:1353–1357.
Article
18. Song KY, Kim SN, Park CH. Laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer: technical and oncologic aspects. Surg Endosc. 2008. 22:655–659.
Article
19. Kwon SJ. Evaluation of the 7th UICC TNM staging system of gastric cancer. J Gastric Cancer. 2011. 11:78–85.
Article
20. Sano T, Aiko T. New Japanese classifications and treatment guidelines for gastric cancer: revision concepts and major revised points. Gastric Cancer. 2011. 14:97–100.
Article
21. Park JM, Jin SH, Lee SR, Kim H, Jung IH, Cho YK, et al. Complications with laparoscopically assisted gastrectomy: multivariate analysis of 300 consecutive cases. Surg Endosc. 2008. 22:2133–2139.
Article
22. Kim JJ, Kim SK, Jun KH, Kang HC, Song KY, Chin HM, et al. Clinical usefulness of a totally laparoscopic gastrectomy. J Korean Gastric Cancer Assoc. 2007. 7:132–138.
Article
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