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Published in: Journal of Gastrointestinal Surgery 4/2008

01-04-2008

Gasless Laparoscopy-Assisted Subtotal Gastrectomy for Early Gastric Cancer: A Novel Minimally Invasive Surgery

Authors: Tzung-Hsin Chou, Ming-Hsun Wu, Ming-Yang Wang, Ching-Yao Yang, Peng-Sheng Lai, Ming-Tsan Lin, Po-Huang Lee

Published in: Journal of Gastrointestinal Surgery | Issue 4/2008

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Abstract

Background

Due to the highly invasive nature of traditional surgery and the limitation of gas-filling laparoscopic surgery in gastric cancers, we developed a new method of gasless laparoscope-assisted subtotal gastrectomy (GLASG). This study investigated the technique and clinical results of this procedure and compared it with traditional radical subtotal gastrectomy (TRSG) for early gastric cancers.

Methodology

From December 2004 to January 2006, 41 patients diagnosed with early gastric cancer were included in the study. All cases underwent subtotal gastrectomy with standard radical lymph node dissection. Twenty patients underwent GLASG, whereas the other 21 patients underwent TRSG. In the GLASG group, we performed our newly developed method using three working ports created at the bilateral subcostal and umbilicus, which provided a 3-dimensional sensation by direct vision through a minilaparotomy and laparoscopic view simultaneously. B-II gastrojejunostomy reconstruction was performed by intracorporeal anastomosis using an endostapler. The TRSG group underwent the standard open method used for gastric cancer. Preoperative characteristics and postoperative recovery between the two groups were compared.

Results

The operative time was comparable between the two groups, but the bleeding was significantly less severe in the GLASG group. Postoperative pain was significantly less in the GLASG group, as well as body temperature from postoperative day 2 to 7. The number of days to first flatus, first oral intake, and discharge were all significantly less in the GLASG group. No major complications were noted in either group.

Conclusions

GLASG may be a feasible and safe procedure for early gastric cancer. Gasless laparoscopic gastrectomy has the advantages of less pain, better cosmetic outcome, and earlier recovery. The newly developed gasless environment may hybridize the advantages of open method and pure laparoscopic method.
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Metadata
Title
Gasless Laparoscopy-Assisted Subtotal Gastrectomy for Early Gastric Cancer: A Novel Minimally Invasive Surgery
Authors
Tzung-Hsin Chou
Ming-Hsun Wu
Ming-Yang Wang
Ching-Yao Yang
Peng-Sheng Lai
Ming-Tsan Lin
Po-Huang Lee
Publication date
01-04-2008
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 4/2008
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-007-0339-0

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