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Surg Endosc. 2009 Aug;23(8):1759-63. doi: 10.1007/s00464-008-0198-0. Epub 2008 Dec 5.

Comparison of long-term outcomes of laparoscopy-assisted and open distal gastrectomy for early gastric cancer.

Author information

1
Department of Surgery, Ewha Medical Center, Ewha Womans University School of Medicine, 911-1 Mok-Dong, Yangcheon-Ku, Seoul, 158-710, Republic of Korea. gsljh@ewha.ac.kr

Abstract

BACKGROUND:

Application of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer (EGC) is still controversial because of scant evidence of long-term safety and feasibility. We evaluated the long-term outcome of LADG compared with conventional open distal gastrectomy (ODG) for EGC.

METHODS:

Between March 1999 and July 2006, 106 patients underwent LADG and 105 patients underwent ODG for EGC. Clinicopathologic characteristics, postoperative outcomes, hospital course, postoperative morbidity, postoperative mortality, and long-term outcomes, including cancer recurrence and survival, were retrospectively compared between the two groups. Survival of all patients was confirmed with 55-month median follow-up.

RESULTS:

Postoperative recovery was significantly faster in the LADG group; passing flatus occurred earlier, starting a liquid diet began sooner, and postoperative hospital stay was shorter (p < 0.05). Mean operation time was significantly longer in the LADG group. Postoperative complications in the LADG group occurred less frequently compared with in the ODG group (4.7% versus 13.3%, p = 0.046). Tumor recurrence occurred in two cases (0.9%) and death related to recurrence occurred in only one patient (0.5%). Overall 5-year survival rate (5-YSR) of all patients was 95.5%, while disease-specific 5-YSR was 98.8%. There was no significant difference in survival rates between the two groups; overall 5-YSR of the ODG and LADG groups was 94.9% and 95.9%, respectively.

CONCLUSIONS:

Our data suggest that LADG for EGC is feasible and safe. We expect the results of the present study to be confirmed by prospective randomized analysis.

PMID:
19057958
DOI:
10.1007/s00464-008-0198-0
[Indexed for MEDLINE]

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