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KMID : 0371320060700030175
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Journal of the Korean Surgical Society
2006 Volume.70 No. 3 p.175 ~ p.181
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A Prospective Study Comparing of Laparoscopy- assisted vs Conventional Open Gastrectomy for Gastric Cancer
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Cho Gyu-Seok
Kim Hyung-Chul
Lee Moon-Soo
Lim Chul-Wan
Shin Eung-Jin
Chu Chong-Woo
Kang Gil-Ho
Kim Yong-Jin
Yu Ki-Won
Lee Hyo-Won
Song Ok-Pyung
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Abstract
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Purpose: The technique of laparoscopic gastrectomy has developed for early gastric cancer, but a few reports have studied the objective advantages of laparoscopic techniques in a prospective manner. The purpose of this study is to compare laparoscopy-assisted gastrectomy (LG) with conventional open gastrectomy (OG) by the operative outcomes, the recovery of bowel function, and the complications in a prospective nonrandomized manner.
Methods: We studied 73 patients with gastric cancer who were diagnosed as stage I (IA, IB) preoperatively between July 2003 and September 2004. 38 patients underwent LG and 35 patients underwent OG. All patients underwent radical lymphadenectomy (D2), and were treated by a single surgeon.
Results: Patients of the two groups were comparable by age, sex, BMI (Body mass index), preoperative stages and mean number of retrived lymph nodes. The mean operative time was shorter in the OG group (P=0.012), and the mean amount of blood loss was significantly less in the LG group than in the OG group (P=0.002). The patients in the LG group recovered bowel function significantly earlier than those in the OG group (P=0.01), thus, the mean hospital stay was significantly shorter in the LG group (P=0.007). The postoperative pain was significantly lower in the LG group (P＜0.001). The postoperative complications were 4 cases in the LG group and 6 cases in the OG group, and there were no conversions and no mortalities.
Conclusion: LG, when compared with OG, has several advantages, including less blood loss, rapid return of gastrointestinal function, less pain, and shorter hospital stay with compromising the cure rate. In addition, for evaluation of the validity of laparoscopic surgery in gastric cancer, a large scaled randomized prospective multicenter study is required. (J Korean Surg Soc 2006;70:175-181)
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KEYWORD
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Laparoscopy, Gastrectomy, Gastric cancer
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