Skip to main content
Top
Published in: Journal of Gastrointestinal Surgery 12/2010

01-12-2010 | Original Article

The Long-Term Results of Distal Gastrectomy by Mini-laparotomy in Early Gastric Cancer Patients

Authors: Hun Jung, Hae Myung Jeon, Han Hong Lee, Kyo Young Song, Cho Hyun Park

Published in: Journal of Gastrointestinal Surgery | Issue 12/2010

Login to get access

Abstract

Introduction

Radical distal gastrectomy by mini-laparotomy is an alternative surgical treatment modality with technical feasibility in early gastric cancer (EGC) patients. The aim of this study is to assess the oncologic feasibility of distal gastrectomy by mini-laparotomy in EGC patients through a long-term survival analysis based on the prospectively collected data.

Patients and Methods

From January 2003 to November 2003, a total of 53 EGC patients who received distal gastrectomy by laparotomy were enrolled in this study. These patients were divided into two groups, that is, the mini-laparotomy group (ML, n = 22) and the conventional laparotomy group (CL, n = 31). A comparative long-term survival analysis was performed.

Results

The hospital stay was significantly shorter in mini-laparotomy group (P = 0.002). However, there were no significant differences in the pathologic results such as the resection margin and the number of harvested lymph nodes. In long-term survival results, there were no significant differences in disease-free and overall survival rate of the patients according to the method of laparotomy.

Conclusions

Radical distal gastrectomy by mini-laparotomy in EGC patients would be also one of the minimally invasive surgical modality in oncologic aspect.
Literature
1.
go back to reference Yoshikawa T, Tsuburaya A, Kobayashi O, Sairenji M, Motohashi H, Noguchi Y. Is D2 lymph node dissection necessary for early gastric cancer? Ann Surg Oncol. 2002;9:401–5.CrossRefPubMed Yoshikawa T, Tsuburaya A, Kobayashi O, Sairenji M, Motohashi H, Noguchi Y. Is D2 lymph node dissection necessary for early gastric cancer? Ann Surg Oncol. 2002;9:401–5.CrossRefPubMed
2.
go back to reference Kasakura Y, Fujii M, Mochizuki F, Asaki H, Kobayashi M. Gastrectomy with D2 lymph node dissection in gastric cancer: a retrospective study at a single institution. Int Surg. 2001;86:50–6.PubMed Kasakura Y, Fujii M, Mochizuki F, Asaki H, Kobayashi M. Gastrectomy with D2 lymph node dissection in gastric cancer: a retrospective study at a single institution. Int Surg. 2001;86:50–6.PubMed
3.
go back to reference Nitti D, Marchet A, Mammano E, Ambrosi A, Belluco C, Mencarelli R, Maino M, Marconato G, Farinati F, Lise M. Extended lymphadenectomy (D2) in patients with early gastric cancer. Eur J Surg Oncol. 2005;31:875–81.CrossRefPubMed Nitti D, Marchet A, Mammano E, Ambrosi A, Belluco C, Mencarelli R, Maino M, Marconato G, Farinati F, Lise M. Extended lymphadenectomy (D2) in patients with early gastric cancer. Eur J Surg Oncol. 2005;31:875–81.CrossRefPubMed
4.
go back to reference Kitano S, Shiraishi N, Kakisako K, Yasuda K, Inomata M, Adachi Y. Laparoscopy-assisted Billroth-I gastrectomy (LADG) for cancer: our 10 years' experience. Surg Laparosc Endosc Percutan Tech 2002;12:204–7.CrossRefPubMed Kitano S, Shiraishi N, Kakisako K, Yasuda K, Inomata M, Adachi Y. Laparoscopy-assisted Billroth-I gastrectomy (LADG) for cancer: our 10 years' experience. Surg Laparosc Endosc Percutan Tech 2002;12:204–7.CrossRefPubMed
5.
go back to reference Soetikno RM, Gotoda T, Nakanishi Y, Soehendra N. Endoscopic mucosal resection. Gastrointest Endosc 2003;57:567–79.CrossRefPubMed Soetikno RM, Gotoda T, Nakanishi Y, Soehendra N. Endoscopic mucosal resection. Gastrointest Endosc 2003;57:567–79.CrossRefPubMed
6.
go back to reference Song J, Oh SJ, Kang WH, Hyung WJ, Choi SH, Noh SH. Robot-assisted gastrectomy with lymph node dissection for gastric cancer: lessons learned from an initial 100 consecutive procedures. Ann Surg. 2009;249:927–32.CrossRefPubMed Song J, Oh SJ, Kang WH, Hyung WJ, Choi SH, Noh SH. Robot-assisted gastrectomy with lymph node dissection for gastric cancer: lessons learned from an initial 100 consecutive procedures. Ann Surg. 2009;249:927–32.CrossRefPubMed
7.
go back to reference Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery. Lancet. 2003;362:1921–8.CrossRefPubMed Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery. Lancet. 2003;362:1921–8.CrossRefPubMed
8.
go back to reference Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Påhlman L, Cuesta MA, Msika S, Morino M, Lacy AM: Colon cancer laparoscopic or open resection study group (COLOR): laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomized trial. Lancet Oncol 2005; 6: 477–484.CrossRefPubMed Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Påhlman L, Cuesta MA, Msika S, Morino M, Lacy AM: Colon cancer laparoscopic or open resection study group (COLOR): laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomized trial. Lancet Oncol 2005; 6: 477–484.CrossRefPubMed
9.
go back to reference Choi YS, Park DJ, Lee HJ, Kim MC, Kim HH, Yang HK. Time required to overcome the laparoscopic assisted distal gastrectomy learning curve in early gastric cancer in terms of operative and clinical parameters. J Korean Surg Soc. 2006;70:370–4. Choi YS, Park DJ, Lee HJ, Kim MC, Kim HH, Yang HK. Time required to overcome the laparoscopic assisted distal gastrectomy learning curve in early gastric cancer in terms of operative and clinical parameters. J Korean Surg Soc. 2006;70:370–4.
10.
go back to reference Nakagoe T, Sawai T, Tsuji T, Ayabe H. Use of minilaparotomy in the treatment of colonic cancer. Br J Surg. 2001;88:831–6.CrossRefPubMed Nakagoe T, Sawai T, Tsuji T, Ayabe H. Use of minilaparotomy in the treatment of colonic cancer. Br J Surg. 2001;88:831–6.CrossRefPubMed
11.
go back to reference Nakagoe T, Matsuo T, Nakamura S, Ryu C, Murakami G, Arisawa K. Risk factors preventing success of a minilaparotomy approach in the resection of colorectal cancer. Dig Surg. 2009;26:236–42.CrossRefPubMed Nakagoe T, Matsuo T, Nakamura S, Ryu C, Murakami G, Arisawa K. Risk factors preventing success of a minilaparotomy approach in the resection of colorectal cancer. Dig Surg. 2009;26:236–42.CrossRefPubMed
13.
go back to reference Syrakos T, Antonitsis P, Zacharakis E, Takis A, Manousari A, Bakogiannis K, Efthimiopoulos G, Achoulias I, Trikoupi A, Kiskinis D. Small-incision (mini-laparotomy) versus laparoscopic cholecystectomy: a retrospective study in a university hospital. Langenbecks Arch Surg. 2004;389:172–7.CrossRefPubMed Syrakos T, Antonitsis P, Zacharakis E, Takis A, Manousari A, Bakogiannis K, Efthimiopoulos G, Achoulias I, Trikoupi A, Kiskinis D. Small-incision (mini-laparotomy) versus laparoscopic cholecystectomy: a retrospective study in a university hospital. Langenbecks Arch Surg. 2004;389:172–7.CrossRefPubMed
14.
go back to reference Turnipseed WD, Hoch JR, Acher CW, Carr SC. Less invasive aortic surgery: the minilaparotomy technique. Surgery. 2000;128:751–6.CrossRefPubMed Turnipseed WD, Hoch JR, Acher CW, Carr SC. Less invasive aortic surgery: the minilaparotomy technique. Surgery. 2000;128:751–6.CrossRefPubMed
15.
go back to reference Fleshman JW, Fry RD, Birnbaum EH, Kodner IJ. Laparoscopic-assisted and minilaparotomy approaches to colorectal diseases are similar in early outcome. Dis Colon Rectum. 1996;39:15–22.CrossRefPubMed Fleshman JW, Fry RD, Birnbaum EH, Kodner IJ. Laparoscopic-assisted and minilaparotomy approaches to colorectal diseases are similar in early outcome. Dis Colon Rectum. 1996;39:15–22.CrossRefPubMed
16.
go back to reference Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma—2nd English edition. Gastric Cancer. 1998;1:10–24.CrossRefPubMed Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma—2nd English edition. Gastric Cancer. 1998;1:10–24.CrossRefPubMed
17.
go back to reference Hur H, Jee SB, Song KY, Kim JJ, Chin HM, Kim W, Jeon HM. Efficacy of minilaparotomy for early gastric cancer. J Korean Surg Soc. 2008;74:192–198. Hur H, Jee SB, Song KY, Kim JJ, Chin HM, Kim W, Jeon HM. Efficacy of minilaparotomy for early gastric cancer. J Korean Surg Soc. 2008;74:192–198.
18.
go back to reference Sobin LH, Wittekind CH, editors. International Union Against Cancer (UICC): TNM lassification of malignant tumours. 6th ed. New York: Wiley, 2006. Sobin LH, Wittekind CH, editors. International Union Against Cancer (UICC): TNM lassification of malignant tumours. 6th ed. New York: Wiley, 2006.
19.
go back to reference Hochwald SN, Brennan MF, Klimstra DS, Kim S, Karpeh MS. Is lymphadenectomy necessary for early gastric cancer? Ann Surg Oncol 1999;6:664–70.CrossRefPubMed Hochwald SN, Brennan MF, Klimstra DS, Kim S, Karpeh MS. Is lymphadenectomy necessary for early gastric cancer? Ann Surg Oncol 1999;6:664–70.CrossRefPubMed
20.
go back to reference Green PH, O'Toole KM, Slonim D, Wang T, Weg A. Increasing incidence and excellent survival of patients with early gastric cancer: experience in a United States medical center. Am J Med 1988;85:658–61.CrossRefPubMed Green PH, O'Toole KM, Slonim D, Wang T, Weg A. Increasing incidence and excellent survival of patients with early gastric cancer: experience in a United States medical center. Am J Med 1988;85:658–61.CrossRefPubMed
21.
go back to reference Onitsuka A, Katagiri Y, Miyauchi T, Yasunaga H, Mimoto H, Ozeki Y. Minilaparotomy for early gastric cancer. Hepatogastroenterology. 2003;50:883–5.PubMed Onitsuka A, Katagiri Y, Miyauchi T, Yasunaga H, Mimoto H, Ozeki Y. Minilaparotomy for early gastric cancer. Hepatogastroenterology. 2003;50:883–5.PubMed
Metadata
Title
The Long-Term Results of Distal Gastrectomy by Mini-laparotomy in Early Gastric Cancer Patients
Authors
Hun Jung
Hae Myung Jeon
Han Hong Lee
Kyo Young Song
Cho Hyun Park
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 12/2010
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-010-1278-8

Other articles of this Issue 12/2010

Journal of Gastrointestinal Surgery 12/2010 Go to the issue