Top

Surgical Endoscopy

Published in:

01-09-2008

Functional evaluation after vagus nerve–sparing laparoscopically assisted distal gastrectomy

Authors: Kazuyuki Kojima, Hiroyuki Yamada, Mikito Inokuchi, Tatuyuki Kawano, Kenichi Sugihara

Published in: Surgical Endoscopy | Issue 9/2008

Abstract

Background

Vagus nerve–sparing laparoscopically assisted distal gastrectomy (Vs-LADG) for early gastric cancer has been introduced to reduce postgastrectomy syndrome, but its clinical and functional outcomes remain unclear.

Methods

Of the 105 patients reviewed in this study, 75 underwent Vs-LADG and 30 underwent laparoscopically assisted distal gastrectomy (LADG) for gastric cancer between January 1999 and May 2006. The clinical and functional outcomes of these two groups were compared.

Results

The clinical and pathologic background between the two groups did not differ. The incidence of gallstone was significantly lower in the Vs-LADG group than in the LADG group (p < 0.05), but no differences existed in duration of surgery, intraoperative blood loss, number of retrieved lymph nodes, time to first flatus after surgery, or length of hospital stay between the two groups.

Conclusions

As shown by the findings, Vs-LADG is a safe and minimally invasive surgery that may decrease the incidence of gallstone formation after gastrectomy.

Matsukuma A, Furusawa M, Tomoda H, Seo Y (1996) A clinicopathological study of asymptomatic gastric cancer. Br J Cancer 74:1647–1650PubMed

Adachi Y, Mori M, Maehara Y, Kitano S, Sugimachi K (1997) Prognostic factors of node-negative gastric carcinoma: univariate and multivariate analyses. J Am Coll Surg 184:373–377PubMed

Maruyama K, Sasako M, Kinoshita T, Sano T, Katai H (1996) Surgical treatment for gastric cancer: the Japanese approach. Semin Oncol 23:360–368PubMed

Siewert JR, Sendler A (1999) The current management of gastric cancer. Adv Surg 33:69–93PubMed

Makuuchi H, Kise Y, Shimada H, Chino O, Tanaka H (1999) Endoscopic mucosal resection for early gastric cancer. Semin Surg Oncol 17:108–116PubMedCrossRef

Ono H (2005) Endoscopic submucosal dissection for early gastric cancer. Chin J Dig Dis 6:119–121PubMedCrossRef

Ohgami M, Otani Y, Kumai K, Kubota T, Kim YI, Kitajima M (1999) Curative laparoscopic surgery for early gastric cancer: five years experience. World J Surg 23:187–193PubMedCrossRef

Adachi Y, Suematsu T, Shiraishi N, Katsuta T, Morimoto A, Kitano S (1999) Quality of life after laparoscopy-assisted Billroth I gastrectomy. Ann Surg 229:49–54PubMedCrossRef

Kodama M, Koyama K (1991) Indications for pylorus-preserving gastrectomy for early gastric cancer located in the middle third of the stomach. World J Surg 15:628–634PubMedCrossRef

10.

Zhang D, Shimoyama S, Kaminishi M (1998) Feasibility of pylorus-preserving gastrectomy with a wider scope of lymph adenectomy. Arch Surg 133:993–997PubMedCrossRef

11.

Miwa K, Kinami S, Sato T, Fujimura T, Miyazaki I (1996) Vagus-saving D2 procedure for early gastric carcinoma (in Japanese). Nippon Geka Gakkai Zasshi (J Jpn Surg Soc) 97:286–290

12.

Kitano S, Iso Y, Moriyama M, Sugimachi K (1994) Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 4:146–148PubMed

13.

Adachi Y, Shiraishi N, Shiromizu A, Bandoh T, Aramaki M, Kitano S (2000) Laparoscopy-assisted Billroth I gastrectomy compared with conventional open gastrectomy. Arch Surg 135:806–810PubMedCrossRef

14.

Mochiki E, Nakabayashi T, Kamimura H, Haga N, Asao T, Kuwano H (2002) Gastrointestinal recovery and outcome after laparoscopy-assisted versus conventional open distal gastrectomy for early gastric cancer. World J Surg 26:1145–1149PubMedCrossRef

15.

Asao T, Kuwano H, Mochiki E (2004) Laparoscopic surgery update for gastrointestinal malignancy. J Gastroenterol 39:309–318PubMedCrossRef

16.

Kojima K, Yamashita T, Inokuchi M, Sugihara K (2002) Technique of vagus nerve–sparing laparoscopy-assisted distal gastrectomy. Dig Endosc 14:103–106CrossRef

17.

Japanese Gastric Cancer Association (1998) Japanese classification of gastric carcinoma, 2nd English edn. Gastric Cancer 1:10–24PubMedCrossRef

18.

Kennedy T, Connell AM, Love AH, MacRae KD, Spencer EF (1973) Selective or truncal vagotomy? Five-year results of a double-blind, randomized controlled trial. Br J Surg 60:944–948PubMedCrossRef

19.

Mujahed Z, Evans JA (1971) The relationship of cholelithiasis to vagotomy. Surg Gynecol Obstet 133:656–658PubMed

20.

Ihasz M, Griffith CA (1981) Gallstones after vagotomy. Am J Surg 141:48–50PubMedCrossRef

21.

Kinami S, Miwa K, Sato T, Miyazaki I (1997) Section of the vagal celiac branch in man reduces glucagon-stimulated insulin release. J Auton Nerv Syst 64:44–48PubMedCrossRef

22.

Isozaki H, Okajima K, Momura E, Ichinona T, Fujii K, Izumi N Takeda Y (1996) Postoperative evaluation of pylorus-preserving gastrectomy for early gastric cancer. Br J Surg 83:266–269PubMedCrossRef

23.

Shinohara H, Sonoda T, Niki M, Nomura E, Nishiguchi K, Tanigawa N (2002) Laparoscopically assisted pylorus-preserving gastrectomy with preservation of the vagus nerve. Eur J Surg 168:55–58PubMedCrossRef

24.

Uyama I, Sakurai Y, Komori Y, Nakamura Y, Syoji M, Tonomura S, Yohida I, Masui T, Ochiai M (2005) Laparoscopic gastrectomy with preservation of the vagus nerve accompanied by lymph node dissection for early gastric carcinoma. J Am Coll Surg 200:140–145PubMedCrossRef

25.

Sakuramoto S, Kikuchi S, Kuroyama S, Futawatari N, Katada N, Kobayashi N, Watanabe M (2006) Laparoscopy-assisted distal gastrectomy for early gastric cancer: experience with 111 consecutive patients. Surg Endosc 20:55–60PubMedCrossRef

26.

Tsuji H, Andoh S, Sakakibara K (2003) The clinical evaluation of vagus nerve–preserving gastric operation with D2 lymph node dissection for early and advanced gastric cancer (in Japanese). Jpn J Gastroenterol Surg 36:78–87

Title: Functional evaluation after vagus nerve–sparing laparoscopically assisted distal gastrectomy
Authors: Kazuyuki Kojima
Hiroyuki Yamada
Mikito Inokuchi
Tatuyuki Kawano
Kenichi Sugihara
Publication date: 01-09-2008
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 9/2008
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-008-0016-8

At a glance: The STEP trials

Springer Medicine

Functional evaluation after vagus nerve–sparing laparoscopically assisted distal gastrectomy

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2008

Laparoscopic antecolic Roux-En-Y gastric bypass with closure of internal defects leads to fewer internal hernias than the retrocolic approach

Re editorial “the controversy regarding hand-assisted colorectal resection”

A meta-analysis of ambulatory versus inpatient laparoscopic cholecystectomy

Sentinel node mapping during laparoscopic distal gastrectomy for gastric cancer

Atypical endoscopic features can be associated with metastasis in rectal carcinoid tumors

Totally laparoscopic extended right hepatectomy