World Journal of Surgery

, 33:2389 | Cite as

Comparison of Invasiveness Between Laparoscopy-Assisted Total Gastrectomy and Open Total Gastrectomy

  • Hideki Kawamura
  • Ryoichi Yokota
  • Shigenori Homma
  • Yukifumi Kondo



Because only a few studies have been performed to date on the invasiveness of laparoscopy-assisted total gastrectomy (LATG) compared with open total gastrectomy (OTG), the minimal invasiveness of LATG has been unclear.


The OTG cohort contained 35 cases, which were performed from April 2003 to October 2005. The LATG cohort contained 46 cases, which were performed from November 2005 to November 2008. Postoperative changes over time in various parameters relating to minimal invasiveness were evaluated. We used the Wong-Baker FACES Pain Rating Scale to evaluate pain. Vital signs and a face scale were analyzed using daily maximum values on postoperative days (POD) 1–7. A hematological examination was performed on the preoperative day and POD 1, 4, 7, and 10. The number of days until oxygen saturation level (SaO2) was 95% or more in room air was used to evaluate respiratory function.


Significantly lower pain scores were obtained in the LATG group on POD 1, 4, 5, and 7. There was a significantly lower body temperature in the LATG group on POD 7. A significantly lower white blood cell count was revealed for LATG patients on POD 10, and for C-reactive protein on POD 1. Significantly higher serum total protein values were observed in the LATG group on POD 1, 4, and 7. Significantly lower blood sugar level was found in the LATG group on POD 4 and 7. The number of days until SaO2 was 95% or more in room air was significantly fewer in the LATG group.


LATG seems to be a less invasive procedure than OTG.


Minimal Invasiveness Open Gastrectomy Oxygen Saturation Level Open Total Gastrectomy Lower White Blood Cell Count 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Adachi Y, Shiraishi N, Shiromizu A et al (2000) Laparoscopy-assisted Billroth I gastrectomy compared with conventional open gastrectomy. Arch Surg 135:806–810PubMedCrossRefGoogle Scholar
  2. 2.
    Tanimura S, Higashino M, Fukunaga Y et al (2005) Laparoscopic distal gastrectomy with regional lymph node dissection for gastric cancer. Surg Endosc 19:1177–1181PubMedCrossRefGoogle Scholar
  3. 3.
    Shiraishi N, Yasuda K, Kitano S (2006) Laparoscopic gastrectomy with lymph node dissection for gastric cancer. Gastric Cancer 9:167–176PubMedCrossRefGoogle Scholar
  4. 4.
    Kawamura H, Okada K, Isizu H et al (2008) Laparoscopic gastrectomy for early gastric cancer targeting as a less invasive procedure. Surg Endosc 22:81–85PubMedCrossRefGoogle Scholar
  5. 5.
    Tanimura S, Higashino M, Fukunaga Y et al (2007) Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer. Br J Surg 94:204–207PubMedCrossRefGoogle Scholar
  6. 6.
    Huscher CG, Mingoli A, Sgarzini G et al (2007) Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer: early and long-term results of a 100-patient series. Am J Surg 194:839–844PubMedCrossRefGoogle Scholar
  7. 7.
    Kim JJ, Song KY, Chin HM et al (2008) Totally laparoscopic gastrectomy with various types of intracorporeal anastomosis using laparoscopic linear staplers: preliminary experience. Surg Endosc 22:436–442PubMedCrossRefGoogle Scholar
  8. 8.
    Usui S, Yoshida T, Ito K, Hiranuma S, Kudo SE, Iwai T (2005) Laparoscopy-assisted total gastrectomy for early gastric cancer: comparison with conventional open total gastrectomy. Surg Laparosc Endosc Percutan Tech 15:309–314PubMedCrossRefGoogle Scholar
  9. 9.
    Topal B, Leys E, Ectors N et al (2008) Determinants of complications and adequacy of surgical resection in laparoscopic versus open total gastrectomy for adenocarcinoma. Surg Endosc 22:980–984PubMedCrossRefGoogle Scholar
  10. 10.
    Mochiki E, Toyomasu Y, Ogata K et al (2008) Laparoscopically assisted total gastrectomy with lymph node dissection for upper and middle gastric cancer. Surg Endosc 22:1997–2002PubMedCrossRefGoogle Scholar
  11. 11.
    Wong DL, Baker CM (1988) Pain in children: comparison of assessment scales. Pediatric Nursing 14:9–17PubMedGoogle Scholar
  12. 12.
    Kitano S, Iso Y, Moriyama M, Sugimachi K (1994) Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 4:146–148PubMedGoogle Scholar
  13. 13.
    Japanese Society for Endoscopic Surgery (2008) The 9th nationwide survey of endoscopic surgery in Japan. J Jpn Soc Endosc Surg 13:499–611Google Scholar
  14. 14.
    Dulucq JL, Wintringer P, Perissat J et al (2005) Completely laparoscopic total and partial gastrectomy for benign and malignant diseases: a single institute’s prospective analysis. J Am Coll Surg 200:191–197PubMedCrossRefGoogle Scholar
  15. 15.
    Pugliese R, Maggioni D, Sansonna F et al (2007) Total and subtotal laparoscopic gastrectomy for adenocarcinoma. Surg Endosc 21:21–27PubMedCrossRefGoogle Scholar
  16. 16.
    Memon MA, Khan S, Yunus RM et al (2008) Meta-analysis of laparoscopic and open distal gastrectomy for gastric carcinoma. Surg Endosc 22:1781–1789PubMedCrossRefGoogle Scholar
  17. 17.
    Huskisson EC (1974) Measurement of pain. Lancet 2:1127–1131PubMedCrossRefGoogle Scholar
  18. 18.
    Tanimura S, Higashino M, Fukunaga Y et al (2006) Respiratory function after laparoscopic distal gastrectomy: an index of minimally invasive surgery. World J Surg 30:1211–1215PubMedCrossRefGoogle Scholar
  19. 19.
    Katsuya H, Sakanashi Y (1989) Simple and noninvasive indicator of pulmonary gas exchange using pulse oximetry. J Clin Monit 5:82–86PubMedCrossRefGoogle Scholar
  20. 20.
    Kurokawa Y, Katai H, Fukuda H et al (2008) Phase II study of laparoscopy-assisted distal gastrectomy with nodal dissection for clinical stage I gastric cancer: Japan Clinical Oncology Group Study JCOG0703. Jpn J Clin Oncol 38:501–503PubMedCrossRefGoogle Scholar
  21. 21.
    Hockenberry MJ, Wilson D, Winkelstein ML (2005) Wong’s essentials of pediatric nursing, 7th edn. Mosby, St. Louis, p 1259Google Scholar

Copyright information

© Société Internationale de Chirurgie 2009

Authors and Affiliations

  • Hideki Kawamura
    • 1
  • Ryoichi Yokota
    • 1
  • Shigenori Homma
    • 1
  • Yukifumi Kondo
    • 1
  1. 1.Department of SurgeryJA Sapporo Kosei HospitalN3, E8, Chuo-kuSapporoJapan

Personalised recommendations