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Short-Term Outcomes of Totally Laparoscopic Total Gastrectomy: Experience With the First Consecutive 112 Cases

World Journal of Surgery volume 38, pages 2662–2667 (2014)Cite this article

Abstract

Introduction

Although laparoscopic distal gastrectomy has become a viable treatment option for gastric cancer, laparoscopic total gastrectomy remains in limited use.

Purpose

The present study was designed to evaluate the short-term outcomes of totally laparoscopic total gastrectomy (TLTG).

Methods

The records of 112 consecutive patients who underwent TLTG for gastric cancer between September 2006 and November 2012 were reviewed, and surgical outcomes were retrospectively investigated.

Results

Neoadjuvant chemotherapy was given to 21 patients (18.8 %). The degree of lymphadenectomy was D1+ in 83 patients (74.1 %) and D2 in 29 (25.9 %). The operation time was 359 min, median intraoperative blood loss was 85 ml, and median total number of harvested lymph nodes was 64. Grade II or higher postoperative complications developed in 25 patients (22.3 %). On univariate analysis, pathologic stages IB to IV (versus stage IA) overlapped esophagojejunostomy (versus functional end-to-end esophagojejunostomy) and operation time >360 min (versus ≤360 min) were related to postoperative morbidity. In the multivariate analysis, operative time and pathologic stage were independent risk factors for postoperative complications.

Conclusions

TLTG is feasible and can be performed with acceptable postoperative morbidity. A longer operating time and more advanced pathologic stage were significantly associated with higher postoperative morbidity.

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Conflict of interest

The authors declare no conflict of interest.

Author information

Affiliations

  1. Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Shigeru Tsunoda, Hiroshi Okabe, Kazutaka Obama, Eiji Tanaka, Shigeo Hisamori, Yousuke Kinjo & Yoshiharu Sakai

Authors
  1. Shigeru Tsunoda
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  2. Hiroshi Okabe
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  3. Kazutaka Obama
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  4. Eiji Tanaka
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  5. Shigeo Hisamori
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  6. Yousuke Kinjo
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  7. Yoshiharu Sakai
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Corresponding author

Correspondence to Shigeru Tsunoda.

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Tsunoda, S., Okabe, H., Obama, K. et al. Short-Term Outcomes of Totally Laparoscopic Total Gastrectomy: Experience With the First Consecutive 112 Cases. World J Surg 38, 2662–2667 (2014). https://doi.org/10.1007/s00268-014-2611-2

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Keywords

  • Gastric Cancer
  • Postoperative Morbidity
  • Anastomotic Stenosis
  • Laparoscopic Total Gastrectomy
  • Dindo Classification