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Laparoscopy‐assisted distal gastrectomy with systemic lymph node dissection: A phase II study following the learning curve
Author(s) -
Fujiwara Michitaka,
Kodera Yasuhiro,
Miura Shinichi,
Kanyama Yasuaki,
Yokoyama Hiroyuki,
Ohashi Norifumi,
Hibi Kenji,
Ito Katsuki,
Akiyama Seiji,
Nakao Akimasa
Publication year - 2005
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20166
Subject(s) - medicine , laparoscopy , lymph node , dissection (medical) , surgery , cancer , gastrectomy , stomach cancer , stage (stratigraphy) , prospective cohort study , paleontology , biology
Background and Objectives A preliminary study on the use of laparoscopy‐assisted approach to treat gastric carcinoma resulted in higher morbidity. Study Design A prospective phase II study of laparoscopy‐assisted distal gastrectomy (LADG) was performed for patients with preoperative diagnosis of T1 N0 stage cancer located in the lower or middle‐third stomach. Bleeding amount, operating time, mortality, morbidity, and the number of lymph node retrieval were recorded and compared with the preliminary series reported previously by the same authors. Results Between 2000 and 2002, 47 patients were accrued. The mean blood loss and postoperative hospital stay were significantly decreased compared with the previous series, whereas the operating time was not. There were no in‐hospital deaths, with the incidence of anastomotic leakage significantly decreased. All patients remain disease‐free to date. Conclusions LADG can be performed safely and morbidity, no longer, is a drawback by experienced hands that have reached plateau of the learning curve, although it remains a time‐consuming procedure. Its application to gastric cancer surgery is feasible for early stage cancer, and its applicability to the treatment of T2 stage cancer will be the next issue to be explored. J. Surg. Oncol. 2005;91:26–32. © 2005 Wiley‐Liss, Inc.