Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Surgical Endoscopy
Published in: Surgical Endoscopy 12/2005

01-12-2005

Laparoscopically assisted distal gastrectomy with standard radical lymph node dissection for gastric cancer

Authors: H. Noshiro, E. Nagai, S. Shimizu, A. Uchiyama, M. Tanaka

Published in: Surgical Endoscopy | Issue 12/2005

Login to get access

Abstract

Background

Laparoscopically assisted distal gastrectomy (LADG) with limited lymph node dissection (D1+alpha) has been used to treat a subset of patients with early gastric cancer. Technical advances have expanded indications for LADG to more advanced gastric cancers. However, little data are available on the feasibility or advantages of LADG with standard radical D2 lymph node dissection for patients with gastric cancer.

Methods

This study reviewed the clinical features of 37 patients who underwent LADG with D2 lymph node dissection for preoperatively diagnosed gastric carcinoma, then compared the results with the features of 31 patients who underwent conventional open distal gastrectomy (ODG) with D2 lymph node dissection.

Results

The laparoscopic procedure was not converted to laparotomy in any patient. There was no operative mortality and no serious morbidity among the patients who underwent LADG with D2 lymph node dissection. As compared with the ODG group, the LADG group had less operative blood loss (p < 0.001), earlier recovery of bowel activity (p = 0.012), and a shorter duration of fever after surgery (p = 0.015), despite the longer operation time (p = 0.007).

Conclusions

According to this study, LADG with D2 lymph node dissection is feasible and provides several advantages similar to those of limited lymph node dissection (D1+alpha). Depending on surgeons’ technical proficiency, LADG can be used with standard radical lymph node dissection for patients with gastric cancers.
Literature
1.
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: 806–810PubMed
2.
Bonenkamp JJ, Hermans J, Sasako M, van de Velde CJ (1999) Extended lymph node dissection for gastric cancer. N Engl J Med 340: 908–914CrossRefPubMed
3.
Bonenkamp JJ, Songun J, Hermans J, Sasako M, Welvaart K, Plukkeo JT, van Elk P, Obertop H, Gouma DJ, Taat CW, van Lanschot J, Meyer S, de Graaf PW, von Meyenfeldt MF, Tilanus H, van de Velde CJH (1995) Randomized comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients. Lancet 345: 745–748CrossRefPubMed
4.
Cuschieri A, Fayers P, Fielding J, Craven J, Bancewicz J, Joypaul V, Cook P (1996) Postoperative morbidity and mortality after D1 and D2 resections for gastric cancer: preliminary results of the MRC randomized controlled surgical trial. The Surgical Cooperative Group. Lancet 347: 995–999
5.
Dent DM, Madden MV, Price SK (1988) Randomized comparison of R1 and R2 gastrectomy for gastric carcinoma. Br J Surg 75: 110–112PubMed
6.
Fujiwara M, Kodera M, Kasai Y, Kanyama Y, Hibi K, Akiyama S, Nakao A (2003) Laparoscopy-assisted distal gastrectomy with systemic lymph node dissection for early gastric carcinoma: review of 43 cases. J Am Coll Surg 196: 75–81CrossRefPubMed
7.
Iriyama K, Asakawa T, Koike H, Nishiwaki H, Suzuki H (1989) Is extensive lymphadenectomy necessary for surgical treatment of intramucosal carcinoma of the stomach? Arch Surg 124: 309–311PubMed
8.
Japanese Gastric Cancer Association (1998) Japanese Classification of Gastric Carcinoma. 2nd English edition. Gastric Cancer 1: 10–24PubMed
9.
Jinnai D (1968) Evaluation of extended radical operation for gastric cancer with regard to lymph node metastasis and follow-up results. Jpn J Cancer Res 3: 225–231
10.
Kitano S, Iso Y, Moriyama M, Sugimachi K (1994) Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 4: 146–148PubMed
11.
Kitano S, Shiraishi N, Fujii K, Yasuda K, Inomata M, Adachi Y (2002) A randomized controlled trial comparing open vs laparoscopy-assisted distal gastrectomy for the treatment of early gastric cancer: an interim report. Surgery 131: S306–311CrossRefPubMed
12.
Kitaoka H, Yoshikawa K, Hirota T, Itabashi M (1984) Surgical treatment of early gastric cancer. Jpn J Clin Oncol 14: 283–293PubMed
13.
Mochiki E, Nakabayashi T, Kamimura H, Haga N, Asano T, Kuwano H (2002) Gastrointestinal recovery and outcome after laparoscopy-assisted versus conventional open distal gastrectomy for early gastric cancer. World J Surg 26: 1145–1149CrossRefPubMed
14.
Nagai Y, Tanimura H, Takifuji K, Kashiwagi H, Yamoto H, Nakatani Y (1995) Laparoscope-assisted Billroth I gastrectomy. Surg Laparosc Endosc 5: 281–287PubMed
15.
Noshiro H, Shimizu S, Nagai E, Ohuchida K, Tanaka M (2003) Laparoscopy-assisted distal gastrectomy for early gastric cancer: is it beneficial for patients with heavier weight? Ann Surg 238: 680–685PubMed
16.
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: 187–193PubMed
17.
Ono H, Kondo H, Gotoda T, Shirao K, Yamaguchi H, Saito D, Hosokawa K, Shimada T, Yoshida S (2001) Endoscopic mucosal resection for treatment of early gastric cancer. Gut 48: 225–229CrossRefPubMed
18.
Reyes CD, Weber KJ, Gagner M, Divino CM (2001) Laparoscopic vs open gastrectomy: a retrospective review. Surg Endosc 15: 928–931CrossRefPubMed
19.
Robertson CS, Chung SC, Woods SD, Griffin SM, Raimes SA, Lau JT, Li AK (1994) A prospective randomized trial comparing R1 subtotal gastrectomy with R3 total gastrectomy for antral cancer. Ann Surg 220: 176–182PubMed
20.
Shimizu S, Uchiyama A, Mizumoto K, Morisaki T, Nakamura K, Shimura H, Tanaka M (2000) Laparoscopically assisted distal gastrectomy for early gastric cancer: is it superior to open surgery? Surg Endosc 14: 27–31CrossRefPubMed
21.
Snedecor GW, Cochran WG (1980) Statistical methods. Ames IA: Iowa State University Press
22.
Tanimura S, Higashino M, Fukunaga Y, Osugi H (2003) Laparoscopic distal gastrectomy with regional lymph node dissection for gastric cancer. Surg Endosc 17: 758–762CrossRefPubMed
23.
Uyama I, Sugiola A, Fujita J, Komori Y, Matsui H, Soga R, Wakayama A, Okamoto K, Ohyama A, Hasumi A (1999) Completely laparoscopic extraperigastric lymph node dissection for gastric malignancies located in the middle or lower third of the stomach. Gastric Cancer 2: 186–190PubMed
Metadata
Title
Laparoscopically assisted distal gastrectomy with standard radical lymph node dissection for gastric cancer
Authors
H. Noshiro
E. Nagai
S. Shimizu
A. Uchiyama
M. Tanaka
Publication date
01-12-2005
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 12/2005
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-005-0175-9

Other articles of this Issue 12/2005

Surgical Endoscopy 12/2005 Go to the issue

Editorial

Time for evidence-based minimal access surgery training—simulate or sink

OriginalPaper

Consensus guidelines for validation of virtual reality surgical simulators

OriginalPaper

Breast duct microendoscopy in nipple discharge: microbrush improves cytology

OriginalPaper

Pneumoperitoneum does not influence trocar site implantation during tumor manipulation in a solid tumor model

OriginalPaper

Experience with laparoscopic gastric resection: results and outcomes for 37 cases

OriginalPaper

Laparoscopic colon surgery performed safely by general surgeons in a community hospital: a review of 154 consecutive cases