Original communicationLaparoscopic assisted distal gastrectomy for early gastric cancer: Five years' experience
Section snippets
Patients
We studied 149 patients with early gastric cancer who had undergone a Billroth I gastrectomy between April 1998 and January 2003 at Gunma University Hospital of Japan. Eighty-nine patients underwent LADG, and 60 underwent conventional open distal gastrectomy (DG). The evaluation of the preoperative stages of gastric cancer was based on examination, including gastrointestinal (GI) endoscopy, endoscopic ultrasonography, and an upper gastrointestinal series. The diagnostic accuracy of preoperative
Results
The clinicopathologic characteristics of the study groups are presented in Table I. The age, gender, histologic type, depth of wall invasion, tumor size, and lymph node metastases did not differ between the LADG and DG groups. Location of neoplasms (lower stomach) and grossly elevated type occurred more often in the LADG group than in the DG group (P < .05).
The perioperative data are summarized in Table II. In the LADG and DG groups, the operative times were 210 ± 6 and 201 ± 5 minutes, while
Discussion
The survival rate of patients with early gastric cancer is better than that of patients with advanced gastric cancer. The 5-year survival rate for early gastric cancer has been reported to be as high as 90%.11, 12 Recently, some researchers have suggested that early gastric cancer can be treated effectively by laparoscopic surgery in selected groups of patients.5, 6, 7, 8, 9 However, the long-term oncologic results of laparoscopic gastrectomy are unknown. LADG can be used safely and affords the
Conclusion
The authors believe that LADG is a safe and useful operation for most early gastric cancers. If the patient is selected properly, LADG can be a curative and minimally invasive treatment for early gastric cancer.
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Supported by grants #13671280 (Dr Mochiki) from the Ministry of Education, Culture, Sports, Science and Technology of Japan.