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KMID : 0978820080110020081
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2008 Volume.11 No. 2 p.81 ~ p.86
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Early Clinical Experience with Laparoscopy-assisted Distal Gastrectomy for Early Gastric Cancer
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Lee Jin-Won
Kim Hae-Sung
Ryu Byoung-Yoon
Kim Hong-Ki
Lee Jeong-Hun
Kim Han-Joon
Jeon Jang-Yeong
Kim Jin-Bong
Choi Young-Hee
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Abstract
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Purpose: For early gastric cancer, even though there are plenty of advantages for using a laparoscope in surgery, it is hard to perform laparoscopic gastrectomy unless surgeons are quite skilled at it. We have experienced more than 400 laparoscopic surgeries such as laparoscopic cholecystectomy, laparoscopic biopsy and laparoscopic splenectomy before the introduction of laparoscopy-assisted distal gastrectomy (LADG). We analyzed the clinical results for our early experiences with 27 patients who underwent LADG by a surgeon who had much experience with open gastrectomy and laparoscopic cholecystectomy.
Methods: We analyzed 27 cases of early gastric cancer that were diagnosed through preoperative evaluation from July 2006 to July 2008. All of the cases were performed by one surgeon. We performed Billroth anastomosis and D1+? lymph node dissection for all the cases. We also compared our results of surgery with the other previous reports.
Results: The mean age was 61.9±11.5 year-old (range: 37∼81); 19 of the patients were men and 8 were women. The Body Mass Index (BMI, kg/m2) was 24.5±3.2 (range: 18∼35); there were 14 overweight peoples over 25 and 13 normal people below the age of 25. 24 cases were diagnosed as early gastric cancer and 3 cases were diagnosed as advanced gastric cancer. We experienced no conversion to open gastrectomy. The length of the operation time was 177±22 minutes. There were 5 complications after surgery: 2 cases of anastomosis site bleeding, one case of colon perforation, one case of postoperative paralytic ileus and one case of delayed gastric emptying.
Conclusion: If we have experienced with other laparoscopic surgeries before starting LADG, we can overcome difficulties of LADG more easily.
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KEYWORD
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Laparoscopy, Gastrectomy, EGC
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