Clinical outcome of laparoscopy-assisted distal gastrectomy for early gastric cancer

Abstract

Laparoscopy-assisted distal gastrectomy has recently spread as a surgical treatment for early gastric cancer. The objective of this study is to inspect the validity of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer. Between October 1999 and August 2010, consecutive 100 patients with early gastric cancer undergone LADG and 76 patients undergone open distal gastrectomy (ODG) in our institute were retrospectively compared for therapeutic outcome. To evaluate the impact of obesity, we classified these patients into two groups based on body mass index (BMI). Blood loss was significantly less (P<0.0001) and postoperative ileus was significantly less frequent (P=0.0113) in the LADG group than the ODG group. There was no significant difference between the LADG and the ODG groups in the cancer recurrence (P=0.9999). In the high BMI patients from the LADG group, significantly longer operation time (P=0.0319) and significantly larger amount of blood loss (P=0.0009) were noted than those in the normal BMI patients. LADG for early gastric cancer is a feasible and, minimally invasive procedure compared favorably with ODG and the oncologic safety is similar to ODG. Therefore, LADG should be recommended as a standard surgical treatment for early gastric cancer.