Feasibility of laparoscopy assisted total gastrectomy in patients with clinical stage I gastric cancer

ArticleinGastric Cancer 17(1) · February 2013with2 Reads
Impact Factor: 3.72 · DOI: 10.1007/s10120-013-0235-0 · Source: PubMed

    Abstract

    Background
    Laparoscopy-assisted total gastrectomy (LATG) for gastric cancer is not yet widespread because of the technical difficulty of reconstruction. We have performed LATG on 100 patients with clinical stage I gastric cancer. This study investigated the short-term outcomes of LATG.
    Methods
    Between September 2001 and September 2012, 100 patients with clinical stage I gastric cancer underwent LATG with D1 plus beta or D2 lymphadenectomy. Roux-en-Y esophagojejunostomy was performed intracorporeally using end-to-side anastomosis with a circular stapler (the purse-string suture method). The primary endpoint was the proportion of postoperative complications during hospitalization.
    Results
    Mean operation time was 249 min; mean blood loss was 182 ml. There were no conversions to open surgery. According to the Clavien–Dindo classification, there were 8 grade II (8 %) and 10 grade IIIa/b (10 %) complications. There were no treatment-related deaths or grade IV complications. The most frequent complication was anastomotic or stump leakage (6 %), followed by pancreatic fistula (5 %). Reoperations were required in two patients with leakage.
    Conclusions
    The short-term outcomes of LATG in our study involving 100 patients were outlined. LATG for gastric cancer patients should be attempted preferably in a clinical trial setting by surgeons with sufficient experience in laparoscopic gastrectomy.