Laparoscopy-assisted distal gastrectomy with systemic lymph node dissection: A phase II study following the learning curve

Background and Objectives A preliminary study on the use of laparoscopy‐assisted approach to treat gastric carcinoma resulted in higher morbidity. Study Design A prospective phase II study of laparoscopy‐assisted distal gastrectomy (LADG) was performed for patients with preoperative diagnosis of T1...

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Bibliographic Details
Published in:Journal of surgical oncology 2005-07, Vol.91 (1), p.26-32
Main Authors: Fujiwara, Michitaka, Kodera, Yasuhiro, Miura, Shinichi, Kanyama, Yasuaki, Yokoyama, Hiroyuki, Ohashi, Norifumi, Hibi, Kenji, Ito, Katsuki, Akiyama, Seiji, Nakao, Akimasa
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anastomosis, Roux-en-Y
Chi-Square Distribution
early gastric carcinoma
Female
Gastrectomy - methods
Humans
laparoscopic surgery
Laparoscopy
Length of Stay
Lymph Node Excision
Lymph Nodes - pathology
lymphadenectomy
Lymphatic Metastasis
Male
Middle Aged
Morbidity
Prospective Studies
Stomach - blood supply
Stomach - pathology
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
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Summary:Background and Objectives A preliminary study on the use of laparoscopy‐assisted approach to treat gastric carcinoma resulted in higher morbidity. Study Design A prospective phase II study of laparoscopy‐assisted distal gastrectomy (LADG) was performed for patients with preoperative diagnosis of T1 N0 stage cancer located in the lower or middle‐third stomach. Bleeding amount, operating time, mortality, morbidity, and the number of lymph node retrieval were recorded and compared with the preliminary series reported previously by the same authors. Results Between 2000 and 2002, 47 patients were accrued. The mean blood loss and postoperative hospital stay were significantly decreased compared with the previous series, whereas the operating time was not. There were no in‐hospital deaths, with the incidence of anastomotic leakage significantly decreased. All patients remain disease‐free to date. Conclusions LADG can be performed safely and morbidity, no longer, is a drawback by experienced hands that have reached plateau of the learning curve, although it remains a time‐consuming procedure. Its application to gastric cancer surgery is feasible for early stage cancer, and its applicability to the treatment of T2 stage cancer will be the next issue to be explored. J. Surg. Oncol. 2005;91:26–32. © 2005 Wiley‐Liss, Inc.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.20166