All 37 cases underwent successful laparoscopic gastrectomy.
+ 29 cases underwent distal gastrectomy with ** Billroth II ** reconstruction,
+ 8 cases total gastrectomy with ** Roux-en-Y ** reconstruction
Zhonghua Yi Xue Za Zhi. 2010 Feb 9;90(6):386-9.
[Article in Chinese]
Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China.
OBJECTIVE: To evaluate the feasibility and clinical efficacy of totally laparoscopic gastrectomy (TLG) for gastric cancer.
METHODS: The investigators retrospectively analyzed 37 cases undergoing TLG for gastric cancer from March 2007 to April 2009 at Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University.
RESULTS: All 37 cases underwent successful TLG. There was neither transfer to open nor laparoscopic assisted surgery. Twenty-nine cases underwent distal gastrectomy with Billroth II reconstruction, 8 cases total gastrectomy with Roux-en-Y reconstruction, including 5 cases with end-to-side esophageal jejunostomy and 3 cases with side-to-side esophageal jejunostomy. Nineteen cases assisted by intraoperative gastroscopy for tumor locating. The operation duration was 210 – 355 min [mean (284 +/- 43) min]. The blood loss was 80 – 450 ml [mean (175 +/- 62) ml]. The number of dissected lymph nodes was 18 – 55 [mean (31 +/- 9)]. Two cases had post-operative complications, with 1 case of pulmonary infection recovering well after symptomatic treatment and 1 case of temporary delayed gastric emptying recovering well after gastrointestinal decompression for 6 days. No mortality was reported. The hospital stay was 6 – 14 d [mean (9 +/- 2) d]. There was no recurrence during the follow-up period of 2 – 25 months.
CONCLUSIONS: For surgeons with rich experiences of laparoscopic surgery, TLG for gastric cancer is both safe and feasible. The short-term efficacy of TLG is satisfactory. Furthermore, TLG conforms more to the concept of minimally invasive surgery and the principle of tumor-free technique.