Laparoscopically assisted total or distal gastrectomy with lymph node dissection for early gastric cancer

Asao, Takayuki; Hosouchi, Yasuo; Nakabayashi, Toshihiro; Haga, Norihiro; Mochiki, Erito; Kuwano, Hiroyuki

doi:10.1046/j.1365-2168.2001.01618.x

Cited by 123 publications

(83 citation statements)

References 10 publications

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“…From an oncological point of view, curative resections with similar survival rates have been obtained in early gastric cancer (EGC) cases [7][8][9][10][11]. However, long-term results in more advanced cases are not still available.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic surgery for gastric cancer: preliminary experience

Carboni¹,

Lepiane²,

Santoro³

et al. 2005

Gastric Cancer

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Section: Introductionmentioning

confidence: 99%

Laparoscopic surgery for gastric cancer: preliminary experience

Carboni¹,

Lepiane²,

Santoro³

et al. 2005

Gastric Cancer

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“…In 1994 Kitano et al [1] reported the first laparoscopic gastric resection and Billroth reconstruction in a patient with early gastric cancer (EGC). Laparoscopic gastric surgery (LGS) has been shown to improve short-term results and quality of life, compared to standard techniques [2,3,4] and has become an acceptable alternative approach in the management of EGC especially in Japan and Korea [5,6,7] . The experience of laparoscopic gastric surgery in the western world is smaller because most of the gastric cancers are seen in an advanced stage and LGS is not considered an acceptable alternative to standard open surgery as yet.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of laparoscopicvsopen gastrectomy in gastric cancer management

Sica¹

2011

WJG

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17|Issue 41| WJG|www.wjgnet.com related and overall survival probability by Kaplan-Meier method showed comparable results (P = 0.81 and P = 0.83, respectively). We found no differences in surgical complications in the 2 groups. There was no conversion to open surgery in this series. CONCLUSION:LGS is as effective as OGS in the management of advanced gastric cancer. However LGS cannot be recommended routinely over OGS for the treatment of advanced gastric cancer.

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“…However, it is difficult to say that methods for reconstruction after resection have reached a level similar to laparotomy. Complications of LADG, including hemorrhage, intraperitoneal abscess, pancreatic fistula, ileus, respiratory complications, and wound infection, account for up to 1%, whereas complications regarding reconstruction for ruptured sutures and stenosis of the anastomotic part, etc., account for 1 to 6% [7][8][9][10][11][12]. This indicates the difficulty of performing anastomosis in laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic distal gastrectomy with intracorporeal handsewn Billroth-I anastomosis (ICHSA)

et al. 2012

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Background The number of cases of laparoscopic surgery has been increasing. Lymph node dissection has been standardized, and the enlarged view provided by laparoscopes allows for the procedure to be performed successfully entirely within the abdominal cavity, but many cases of reconstruction using the Billroth-I method are performed under direct vision through a small incision. In this study, by placing an anchor thread on a suture line on the lesser curvature of the stomach, we simplified the procedure for handsewn anastomosis and safely performed gastroduodenal anastomosis at low cost to obtain good results. Methods From January 2009 to December 2010, we performed handsewn gastroduodenal anastomosis in 18 cases. After performing lymph node dissection, the duodenum and the stomach were separated using an automatic stapling device. Anchor sutures were placed on the suture line of the lesser curvature of the stomach. First, the seromuscular layer of the stomach and the seromuscular layer of the duodenum were sutured by performing interrupted suturing using an extracorporeal knot-tying method. With the stomach and the duodenum in a fixed state, the anastomosis area was opened. The thread of the anchor suture was pulled toward the abdominal wall, and then all layers of the stomach and the duodenum at the posterior wall were continuously sutured. Similarly, for the anterior wall, all layers were continuously sutured from the lesser curvature toward the greater curvature. Results We performed this anastomotic procedure in 18 patients with early gastric carcinoma. The mean time required for the anastomosis was 64.6 ± 17.1 min, and the estimated blood loss was 53.1 ± 91 g. All operations were curative, and the mean number of retrieved lymph node was 27.1 ± 10.8. A nasogastric tube was removed on the first or second day. An upper gastrointestinal series performed on postoperative days 5-6 showed no anastomotic leakage and normal transit. Oral intake was started on days 6-7. Postoperative complications included one case of a ruptured suture, but this was resolved through a conservative approach. There was no mortality. Postoperative endoscopy revealed that the anastomosis area was extremely soft, and no abnormalities were observed. Moreover, the only costs related to the anastomosis were for the thread and needles, and although more time was required compared with mechanical anastomosis, the cost was extremely low. Conclusions We performed gastroduodenal anastomosis under a total laparoscopic approach by handsewn. This method is economical, because it does not require the use of machinery for anastomosis, and the duodenal stump is short. We believe that this method, which can be performed in a similar manner even for obese patients, can be used as a standard method of anastomosis.

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Laparoscopically assisted total or distal gastrectomy with lymph node dissection for early gastric cancer

Cited by 123 publications

References 10 publications

Laparoscopic surgery for gastric cancer: preliminary experience

Laparoscopic surgery for gastric cancer: preliminary experience

Comparative study of laparoscopicvsopen gastrectomy in gastric cancer management

Laparoscopic distal gastrectomy with intracorporeal handsewn Billroth-I anastomosis (ICHSA)

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