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 4/2011

01-04-2011

A totally laparoscopic distal gastrectomy with gastroduodenostomy (TLDG) for improvement of the early surgical outcomes in high BMI patients

Authors: Min Gyu Kim, Hironori Kawada, Beom Su Kim, Tae Hwan Kim, Kap Choong Kim, Jeong Hwan Yook, Byung Sik Kim

Published in: Surgical Endoscopy | Issue 4/2011

Login to get access

Abstract

Objective

To evaluate the effectiveness of totally laparoscopic distal gastrectomy with gastroduodenostomy (TLDG), we compared its early surgical outcomes with those of laparoscopy-assisted distal gastrectomy with gastroduodenostomy (LADG).

Methods

We retrospectively analyzed early surgical outcomes in 567 patients who underwent laparoscopic gastrectomy for gastric cancer between January 2009 and March 2010. The patients were divided into those with underwent TLDG and those with underwent LADG. Their surgical outcomes were analyzed according to the WHO Asia–Pacific Obesity classification.

Results

In overall patients, TLDG showed the significant results of early surgical outcomes. But more importantly, in the analysis of early surgical outcomes for obese patients, we found that TLDG could improve overall complication rate (p = 0.031), time to first flatus (p = 0.009), time to commencement of soft diet (p < 0.001), administration of analgesics (p = 0.019), pain score (Numeric Rating Scale, NRS), and hospital discharge (p = 0.003).

Conclusions

We suggested that TLDG contributes to the improvement of early surgical outcomes. We further suggest that TLDG in obese patients could be the best way to improve early surgical outcomes, including the bowel movement, pain score, overall complication rate, and hospital discharge.
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 135:806–810PubMedCrossRef
2.
Asao T, Hosouchi Y, Nakabayashi T, Haga N, Mochiki E, Kuwano H (2001) Laparoscopically assisted total or distal gastrectomy with lymph node dissection for early gastric cancer. Br J Surg 88:128–132PubMedCrossRef
3.
Hayashi H, Ochiai T, Shimada H, Gunji Y (2005) Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancer. Surg Endosc 19:1172–1176PubMedCrossRef
4.
Kim YW, Baik YH, Yun YH, Nam BH, Kim DH, Choi IJ, Bae JM (2008) Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg 248:721–727PubMedCrossRef
5.
Kitano S, Shiraishi N, Kakisako K, Yasuda K, Inomata M, Adachi Y (2002) Laparoscopy-assisted Billroth-I gastrectomy (LADG) for cancer: our 10 years’ experience. Surg Laparosc Endosc Percutan Tech 12:204–207PubMedCrossRef
6.
Lee JH, Han HS (2005) A prospective randomized study comparing open vs laparoscopy-assisted distal gastrectomy in early gastric cancer: early results. Surg Endosc 19:168–173PubMedCrossRef
7.
Lee SI, Choi YS, Park DJ, Kim HH, Yang HK, Kim MC (2006) Comparative study of laparoscopy-assisted distal gastrectomy and open distal gastrectomy. J Am Coll Surg 202:874–880PubMedCrossRef
8.
Mochiki E, Toyomasu Y, Ogata K, Andoh H, Ohno T, Aihara R, Asao T, Kuwano H (2008) Laparoscopically assisted total gastrectomy with lymph node dissection for upper and middle gastric cancer. Surg Endosc 22:1997–2002PubMedCrossRef
9.
Park JM, Jin SH, Lee SR, Kim H, Jung IH, Cho YK, Han SU (2008) Complications with laparoscopically assisted gastrectomy: multivariate analysis of 300 consecutive cases. Surg Endosc 22:2133–2139PubMedCrossRef
10.
Ryu KW, Kim YW, Lee JH, Nam BH, Kook MC, Choi IJ, Bae JM (2008) Surgical complications and the risk factors of laparoscopy-assisted distal gastrectomy in early gastric cancer. Ann Surg Oncol 15:1625–1631PubMedCrossRef
11.
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
12.
Song KY, Kim SN, Park CH (2008) Laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer: technical and oncologic aspects. Surg Endosc 22:655–659PubMedCrossRef
13.
Kitano S, Iso Y, Moriyama M, Sugimachi K (1994) Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 4:146–148PubMed
14.
Kanaya S, Gomi T, Momoi H, Tamaki N, Isobe H, Katayama T, Wada Y, Ohtoshi M (2002) Delta-shaped anastomosis in totally laparoscopic Billroth I gastrectomy: new technique of intraabdominal gastroduodenostomy. J Am Coll Surg 195:284–287PubMedCrossRef
15.
Kim JJ, Song KY, Chin HM, Kim W, Jeon HM, Park CH, Park SM (2008) Totally laparoscopic gastrectomy with various types of intracorporeal anastomosis using laparoscopic linear staplers: preliminary experience. Surg Endosc 22:436–442PubMedCrossRef
16.
Song KY, Park CH, Kang HC, Kim JJ, Park SM, Jun KH, Chin HM, Hur H (2008) Is totally laparoscopic gastrectomy less invasive than laparoscopy-assisted gastrectomy? Prospective, multicenter study. J Gastrointest Surg 12:1015–1021PubMedCrossRef
17.
Tanimura S, Higashino M, Fukunaga Y, Takemura M, Nishikawa T, Tanaka Y, Fujiwara Y, Osugi H (2008) Intracorporeal Billroth 1 reconstruction by triangulating stapling technique after laparoscopic distal gastrectomy for gastric cancer. Surg Laparosc Endosc Percutan Tech 18:54–58PubMedCrossRef
18.
Ojima T, Iwahashi M, Nakamori M, Nakamura M, Naka T, Ishida K, Ueda K, Katsuda M, Iida T, Tsuji T, Yamaue H (2009) Influence of overweight on patients with gastric cancer after undergoing curative gastrectomy. Arch Surg 144:351–358PubMedCrossRef
19.
Lee HJ, Kim HH, Kim MC, Ryu SY, Kim W, Song KY, Cho GS, Han SU, Hyung WJ, Ryu SW (2009) The impact of a high body mass index on laparoscopy assisted gastrectomy for gastric cancer. Surg Endosc 23:2473–2479PubMedCrossRef
20.
Uyama I, Sugioka 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 2:186–190PubMedCrossRef
Metadata
Title
A totally laparoscopic distal gastrectomy with gastroduodenostomy (TLDG) for improvement of the early surgical outcomes in high BMI patients
Authors
Min Gyu Kim
Hironori Kawada
Beom Su Kim
Tae Hwan Kim
Kap Choong Kim
Jeong Hwan Yook
Byung Sik Kim
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 4/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-010-1319-0

Other articles of this Issue 4/2011

Surgical Endoscopy 4/2011 Go to the issue

OriginalPaper

Video-assisted thoracoscopic surgery (VATS) lobectomy using a standardized anterior approach

OriginalPaper

Trends and results of the first 5 years of Fundamentals of Laparoscopic Surgery (FLS) certification testing

OriginalPaper

Synthetic polymer–tissue adhesion using an ultrasonic scalpel

OriginalPaper

Laparoendoscopic single-site surgery for the treatment of benign adnexal diseases: a pilot study

Dynamic Manuscript

Sphincterotome stricturoplasty for long ampullary stenoses and benign biliary strictures (with video)

Letter

Should the wheel be reinvented in a human study?