Is totally laparoscopic gastrectomy less invasive than laparoscopy-assisted gastrectomy?: prospective, multicenter study.
In: Journal of Gastrointestinal Surgery, Jg. 12 (2008-06-01), Heft 6, S. 1015-1021
Online
academicJournal
Zugriff:
Background: Laparoscopic surgery has been adopted for the treatment of gastric cancer, and many reports have confirmed its favorable outcomes. Most surgeons prefer to laparoscopy-assisted gastrectomy using minilaparotomy rather than totally laparoscopic procedures because of technical difficulties of intracorporeal anastomosis. We conducted this study to compare laparoscopy-assisted distal gastrectomy with totally laparoscopic distal gastrectomy. In addition, laparoscopic procedures were compared with open distal gastrectomy. Material and Methods: This prospective, nonrandomized, multicenter study enrolled 60 patients with early gastric cancer at three branch hospitals of our institutes. Twenty-five- to 30-cm-long mid-line incision, 5-cm midline or transverse incision, and 3-cm U-shaped incision were used in open distal gastrectomy, laparoscopy-assisted distal gastrectomy, and totally laparoscopic distal gastrectomy, respectively. Postoperative outcomes, immunologic changes, and operation-related costs were compared between the three groups. Results: There was no difference in gender, mean age, body mass index, and tumor characteristics between the three groups. No operation-related death occurred. Estimated blood loss, number of additional analgesics use, first flatus, and soft meal diet time were significantly different between the three groups (P < 0.05). In totally laparoscopic distal gastrectomy, the time to first flatus was significantly shorter than laparoscopy-assisted distal gastrectomy (3.7 vs. 2.8 days, in laparoscopy-assisted distal gastrectomy and totally laparoscopic distal gastrectomy, respectively, P < 0.05). White blood cell count and C-reactive protein level at postoperative day 1 were significantly higher in open distal gastrectomy than the other groups; however, there was no difference between laparoscopy-assisted distal gastrectomy and totally laparoscopic distal gastrectomy. The operation-related costs were significantly greater in totally laparoscopic distal gastrectomy (P < 0.05). Conclusion: Although totally laparoscopic distal gastrectomy needs more cost, totally laparoscopic distal gastrectomy provides shorter bowel recovery time than laparoscopy-assisted distal gastrectomy. [ABSTRACT FROM AUTHOR]
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Is totally laparoscopic gastrectomy less invasive than laparoscopy-assisted gastrectomy?: prospective, multicenter study.
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Autor/in / Beteiligte Person: | Kyo Young Song ; Cho Hyun Park ; Han Chol Kang ; Kim, Jin-Jo ; Seung Man Park ; Kyong Hwa Jun ; Hyung Min Chin ; Hur, Hoon ; Song, Kyo Young ; Park, Cho Hyun ; Kang, Han Chol ; Park, Seung Man ; Jun, Kyong Hwa ; Chin, Hyung Min |
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Zeitschrift: | Journal of Gastrointestinal Surgery, Jg. 12 (2008-06-01), Heft 6, S. 1015-1021 |
Veröffentlichung: | 2008 |
Medientyp: | academicJournal |
ISSN: | 1091-255X (print) |
DOI: | 10.1007/s11605-008-0484-0 |
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