Original Article

Surgical Endoscopy And Other Interventional Techniques

, Volume 19, Issue 9, pp 1172-1176

First online:

Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancer

  • H. HayashiAffiliated withResearch Center for Frontier Medical EngineeringDepartment of Academic Surgery, Graduate School of Medicine, Chiba University Email author 
  • , T. OchiaiAffiliated withDepartment of Academic Surgery, Graduate School of Medicine, Chiba University
  • , H. ShimadaAffiliated withDepartment of Academic Surgery, Graduate School of Medicine, Chiba University
  • , Y. GunjiAffiliated withDepartment of Academic Surgery, Graduate School of Medicine, Chiba University

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Abstract

Background

Laparoscopy-assisted surgery with extraperigastric lymph node dissection for gastric cancers has been described, but the clinical benefits of these surgeries still are unclear. Short-term clinical outcomes were compared between laparoscopy-assisted distal gastrectomy (LADG) and conventional open distal gastrectomy (ODG) for early gastric cancer in a prospective randomized fashion.

Methods

For this study, 28 patients with early gastric cancers in the lower half of the stomach were randomly assigned to either LADG (n = 4) or ODG (n = 14). Postoperative pain, levels of acute inflammatory responses, and pathologic evaluation of the operative specimens were compared.

Results

The LADG group required a significantly shorter period of postoperative epidural anesthesia, showed significantly lower levels of serum interleukin-6 and C-reactive protein, and had no major postsurgery complications. Pathologic examinations showed that surgery was equally radical in the two groups.

Conclusion

The findings show that LADG with extraperigastric lymph node dissection is a safe and less invasive alternative to the open procedure.

Key words:

Gastric cancer Distal gastrectomy Extended lymphadenectomy Laparoscopy Randomized control trial Billroth I reconstruction