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Surgical Endoscopy

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01-06-2009

Laparoscopic-assisted distal gastrectomy versus open distal gastrectomy for advanced gastric cancer

Authors: Sang Il Hwang, Hyung Ook Kim, Chang Hak Yoo, Jun Ho Shin, Byung Ho Son

Published in: Surgical Endoscopy | Issue 6/2009

Abstract

Background

Laparoscopic-assisted gastric surgery has become an option for the treatment of early gastric cancer. However, there are few reports of laparoscopic surgery in the management of advanced gastric cancer. In this study we describe our experience with laparoscopic-assisted distal gastrectomy (LADG) for advanced gastric cancer (AGC).

Methods

Between November 2004 and June 2007, 47 patients with AGC underwent LADG at our hospital, and 45 of those patients were enrolled in this study. These patients were compared with 83 patients who had AGC and underwent conventional open distal gastrectomy (ODG) during the same period.

Results

Operation time was significantly longer in the LADG group than in the ODG group. Estimated blood loss in the LADG group was significantly less than in the ODG group. Time to ambulation and first flatus and duration of analgesic medication were significantly shorter in the LADG group. The morbidity and mortality rate were also lower than in the ODG group, with no statistically significant difference. The distance of the proximal resection margin showed no significant difference compared with ODG (6.3 ± 0.9 versus 6.5 ± 0.9 cm; p = 0.228). The mean number of nodes resected with LADG was 35.6 ± 14.2, and that with ODG was 38.3 ± 11.4 (p = 0.269). The mean follow-up for the LADG group was 23.6 months (range 9–40 months). In the LADG group, recurrence was observed in six patients (13.3%). Three patients had recurrence and died after 10 (IIIB), 11 (IIIA), and 13 (IIIB) months.

Conclusions

LADG with extended lymphadenectomy for AGC is a feasible and safe procedure and has several advantages. Moreover, this method can achieve a radical oncologic equivalent resection. Indications for LADG with extended lymphadenectomy could be expanded in the treatment of locally advanced gastric cancer.

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Title: Laparoscopic-assisted distal gastrectomy versus open distal gastrectomy for advanced gastric cancer
Authors: Sang Il Hwang
Hyung Ook Kim
Chang Hak Yoo
Jun Ho Shin
Byung Ho Son
Publication date: 01-06-2009
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 6/2009
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-008-0140-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic-assisted distal gastrectomy versus open distal gastrectomy for advanced gastric cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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