Abstract
Background
Totally laparoscopic distal gastrectomy (TLDG) with intracorporeal anastomosis has been introduced to achieve safer anastomosis with good vision, and a small wound. However, little is known about the surgical outcomes of newly introduced TLDG compared with established procedures of laparoscopy-assisted gastrectomy (LADG) with extracorporeal anastomosis.
Methods
This retrospective study included 114 patients who underwent laparoscopic distal gastrectomy (LDG) between January 2010 and September 2012. The patients were classified into two groups according to the approach of reconstruction (LADG group: n = 74; TLDG group: n = 40). The parameters analyzed included patients, operation details, and operative outcomes.
Results
No complication was observed in the TLDG group. Surgical outcomes of the TLDG group, such as mean operation time, estimated blood loss, and rate of conversion to laparotomy were not inferior to the LADG group. Furthermore, postoperative hospital stay of the TLDG group was significantly shorter than the LADG group (p < 0.05).
Conclusion
Surgical outcomes in the newly introduced phase of TLDG were safe as well as feasible compared with established LADG. TLDG has several advantages over LADG, such as shorter post-hospital stay, no incidence of operative complication, adequate working space, and small wound size. Although prospective, randomized control studies are warranted, we submit that TLDG can be used as a standard procedure for LDG.
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Disclosures
Drs. Shingo Kanaji, Hitoshi Harada, Shunji Nakayama, Takashi Yasuda, Taro Oshikiri, Kentaro Kawasaki, Masashi Yamamoto, Tatsuya Imanishi, Tetsu Nakamura, Satoshi Suzuki, Kenichi Tanaka, Yasuhiro Fujino, Masahiro Tominaga, and Yoshihiro Kakeji have no commercial association that might create a conflict of interest in connection with any of the products mentioned in this article.
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Kanaji, S., Harada, H., Nakayama, S. et al. Surgical outcomes in the newly introduced phase of intracorporeal anastomosis following laparoscopic distal gastrectomy is safe and feasible compared with established procedures of extracorporeal anastomosis. Surg Endosc 28, 1250–1255 (2014). https://doi.org/10.1007/s00464-013-3315-7
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DOI: https://doi.org/10.1007/s00464-013-3315-7