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Laparoscopically assisted total gastrectomy with lymph node dissection for upper and middle gastric cancer

Surgical Endoscopy volume 22, pages 1997–2002 (2008)Cite this article

Abstract

Background

In recent years, laparoscopic gastrectomy has been applied for the treatment of gastric cancer in Japan and Western countries. This report describes the short- and long-term results for patients with gastric cancer who underwent laparoscopically assisted total gastrectomy (LATG) with lymph node dissection.

Methods

From September 1999 to December 2007, 20 patients underwent LATG, and 18 underwent conventional open total gastrectomy (OTG) for upper and middle gastric cancer. The indications for LATG included depth of tumor invasion limited to the mucosa or submucosa and absence of lymph node metastases in preoperative examinations. The LATG and OTG procedures for gastric cancer were compared in terms of pathologic findings, operative outcome, complications, and survival.

Results

No significant difference was found between LATG and OTG in terms of operation time (254 vs 248 min.), number of lymph nodes (26 vs 35), complication rate (25% vs 17%), or 5-year cumulative survival rate (95% vs 90.9%). Differences between LATG and OTG were found with regard to blood loss (299 vs 758 g) and postoperative hospitalization (19 vs 29 days).

Conclusion

For properly selected patients, laparoscopically assisted total gastrectomy can be a curative and minimally invasive treatment for early gastric cancer.

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References

  1. Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N (2007) A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg 245:68–72

    PubMed  Article  Google Scholar 

  2. Mochiki E, Kaniyama Y, Aihara R, Nakabayashi T, Asao T, Kuwano H (2005) Laparoscopic assisted distal gastrectomy for early gastric cancer: five years experience. Surgery 137:317–322

    PubMed  Article  Google Scholar 

  3. Huscher CGS, Mingoli A, Sgarzini G, Sansonetti A, Di Paola M, Recher A, Ponzano C (2005) Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg 241:232–237

    PubMed  Article  Google Scholar 

  4. Adachi Y, Suematsu T, Shiraishi N, Katsuta T, Morimoto A, Kitano S, Akazawa K (1999) Quality of life after laparoscopy-assisted Billroth I gastrectomy. Ann Surg 229:49–54

    PubMed  Article  CAS  Google Scholar 

  5. Mochiki E, Nakabayashi T, Kamimura H, Haga N, Asao T, Kuwano H (2002) Gastrointestinal recover and outcome after laparoscopy-assisted versus conventional open distal gastrectomy for early gastric cancer. World J Surg 26:1145–1149

    PubMed  Article  Google Scholar 

  6. Tanimura S, Higashino M, Fukunaga Y, Kishida S, Ogata A, Fujiwara Y, Osugi H (2007) Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer. Br J Surg 94:204–207

    PubMed  Article  CAS  Google Scholar 

  7. Mochiki E, Kamimura H, Haga N, Asao T, Kuwano H (2002) The technique of laparoscopically assisted total gastrectomy with jejunal interposition for early gastric cancer. Surg Laparosc 16:540–544

    CAS  Google Scholar 

  8. Huscher CGS, Mingoli A, Sgarzini G, Brachini G, Binda B, Paola MD, Ponzano C (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-patients series. Am J Surg 194:839–844

    PubMed  Article  Google Scholar 

  9. Pugliese R, Maggioni D, Sansonna F, Scandroglio I, Ferrari GC, Di Lernia S, Costanzi A, Pauna J, de Martini P (2007) Total and subtotal laparoscopic gastrectomy for adenocarcinoma. Surg Endosc 21:21–27

    PubMed  Article  CAS  Google Scholar 

  10. Dulucq JL, Wintringer P, Perissat J, Mahajna A (2005) Completely laparoscopic total and partial gastrectomy for benign and malignant diseases: a single institute’s prospective analysis. J Am Coll Surg 200:191–197

    PubMed  Article  Google Scholar 

  11. Omori T, Nakajima K, Endo S, Takahashi T, Hasegawa J, Nishida T (2006) Laparoscopically assisted total gastrectomy with jejuna pouch interposition. Surg Endosc 20:1497–1500

    PubMed  Article  CAS  Google Scholar 

  12. Tanimura S, Higashino M, Fukunaga Y, Kishida S, Ogata A, Fujiwara Y, Osugi H (2007) Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer. Br J Surg 94:204–207

    PubMed  Article  CAS  Google Scholar 

  13. Asao T, Hosouchi Y, Nakabayashi T, Haga N, Mochiki E, Kuwano H (2001) Laparoscopically assisted total or distal gastrectomy with lymph node dissection for early gastric cancer. Br J Surg 88:128–132

    PubMed  Article  CAS  Google Scholar 

  14. Ganpathi IS, So JBY, Ho KY (2006) Endoscopic ultrasonography for gastric cancer: does it influence treatment? Surg Endosc 20:559–562

    PubMed  Article  CAS  Google Scholar 

  15. Davies MM, Larson DW (2004) Laparoscopic surgery for colorectal cancer: the state of the art. Surg Oncol 13:111–118

    PubMed  Article  CAS  Google Scholar 

  16. Shoup M, Brennan MF, Karpeh MS, Gillern Sm, McMahon RL, Conlon KC (2002) Port-site metastasis after diagnostic laparoscopy for upper gastrointestinal tract malignancies: an uncommon entity. Ann Surg Oncol 9:632–636

    PubMed  Article  Google Scholar 

  17. Lee YJ, Ha WS, Park ST, Choi SK Hong SC (2007) Port-site recurrence after laparoscopy-assisted gastrectomy: report of the first case. J Laparoendosc Adv Surg Tech A 17:455–457

    PubMed  Article  Google Scholar 

  18. Adachi Y, Shiraishi N, Ikebe K, Aramaki M, Bandoh T, Kitano S (2001) Evaluation of the cost for laparoscopic-assisted Billroth I gastrectomy. Surg Endosc 15:932–936

    PubMed  Article  CAS  Google Scholar 

  19. Song KY, Park CH, Kang HC, Kim JJ, Park SM, Jun KH, Chin HM, Hur H (2008) Is totally laparoscopic gastrectomy less invasive than laparoscopy-assisted gastrectomy? Prospective, multicenter study. J Gastrointest Surg 12:1015–1021

    PubMed  Article  Google Scholar 

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Affiliations

  1. Department of General Surgical Science, Faculty of Medicine, Gunma University, 3-39-22, Showa-machi, Maebashi, 371-8511, Japan

    Erito Mochiki, Yoshitaka Toyomasu, Kyouichi Ogata, Hiroyuki Andoh, Tetsuro Ohno, Ryusuke Aihara, Takayuki Asao & Hiroyuki Kuwano

Authors
  1. Erito Mochiki
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  2. Yoshitaka Toyomasu
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  3. Kyouichi Ogata
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  4. Hiroyuki Andoh
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  5. Tetsuro Ohno
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  6. Ryusuke Aihara
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  7. Takayuki Asao
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  8. Hiroyuki Kuwano
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Correspondence to Erito Mochiki.

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Mochiki, E., Toyomasu, Y., Ogata, K. et al. Laparoscopically assisted total gastrectomy with lymph node dissection for upper and middle gastric cancer. Surg Endosc 22, 1997–2002 (2008). https://doi.org/10.1007/s00464-008-0015-9

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  • DOI: https://doi.org/10.1007/s00464-008-0015-9

Keywords

  • Gastric cancer
  • Laparoscopy
  • Total gastrectomy