TITLE:
Totally Laparoscopic Total Gastrectomy with D2 Lymphadenectomy for Advanced Gastric Cancer
AUTHORS:
Hironobu Takano, Yuma Ebihara, Yo Kurashima, Soichi Murakami, Toshiaki Shichinohe, Satoshi Hirano
KEYWORDS:
Advanced Gastric Cancer, Totally Laparoscopic Total Gastrectomy, D2 Lymphadenectomy
JOURNAL NAME:
Surgical Science,
Vol.6 No.6,
June
16,
2015
ABSTRACT: Introductions: Gastrectomy, which is the standard surgical procedure for gastric
cancer, has gradually come to be performed laparoscopically. Laparoscopic distal
gastrectomy (LDG) has been adopted gradually and performed for advanced gastric
cancer. However, laparoscopic total gastrectomy (LTG) has not been as widely accepted
as LDG due to technical difficulties, especially with reconstruction and proper
D2 lymphadenectomy. The purpose of the current study was to determine the utility
of TLTG with concomitant splenectomy and D2 lymphadenectomy (TLTGS) for advanced
gastric cancer (AGC). Materials and Methods: Between January 2006 and May 2014,
10 consecutive patients who underwent TLTGS for AGC and 76 patients who underwent
TLTG with D1 lymphadenectomy were included in this study. These two groups were
compared in terms of perioperative results, with assessment of intraoperative and
postoperative outcomes. Results: There were no significant differences in patients’
characteristics between the two groups. Operative time was longer in the TLTGS group
than in the TLTG group. However, the rate of patients with postoperative complications
including major complications was not different between the groups, and no patient
in the TLTGS group had anastomotic leakage or pancreatic fistula. Conclusions: In
the short-term, TLTGS had good postoperative outcomes and was useful and acceptable
for AGC.