The Learning Curve of Laparoscopy-assisted Distal Gastrectomy (LADG) for Cancer.
10.5230/jkgca.2008.8.4.232
- Author:
Kab Choong KIM
1
;
Jeong Hwan YOOK
;
Ji Eun CHOI
;
Oh CHEONG
;
Jeong Taek LIM
;
Sung Tae OH
;
Byung Sik KIM
Author Information
1. Department of Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea. bskim@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Stomach cancer;
Laparoscopy-assisted gastrectomy;
Early gastric cancer
- MeSH:
Adenocarcinoma;
Female;
Gastrectomy;
Humans;
Laparoscopy;
Learning;
Learning Curve;
Lymph Node Excision;
Lymph Nodes;
Male;
Pain, Postoperative;
Postoperative Complications;
Quality of Life;
Retrospective Studies;
Stomach Neoplasms
- From:Journal of the Korean Gastric Cancer Association
2008;8(4):232-236
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Laparoscopic surgery for gastric cancer was introduced in the past decade because it was considered less invasive than open surgery, and this results in less postoperative pain, faster recovery and an improved quality of life. Several studies have demonstrated the safety and feasibility of this procedure. We examined the outcome of performing laparoscopic surgery for gastric cancer over the last two year. MATERIALS AND METHODS: From April 2004 to December 2006, 329 patients with gastric adenocarcinoma underwent a laparoscopy-assisted distal gastrectomy with lymph node dissection. The data was retrospectively reviewed in terms of the clinicopathologic findings, the perioperative outcomes and the complications. RESULTS: The total patient group was comprised 196 men (59.6%) and 133 women (40.4%). The mean BMI was 23.6 and the mean tumor size was 2.7 cm. The mean number of harvested lymph node was 22.7, and this was 18.6 before 30 cases and 23.1 after 30 cases, and the difference was significant (P=0.02). The mean operation time was 180.9 min, and this was than 287.9 min before 30 cases and 170.2 min after 30 cases. After 30 cases, there was a significant improvement of the operation time (P<0.01). The mean incision length after 30 cases was shorter than that before 30 cases (P<0.01). Postoperative complications occurred in 24 (7.3%) of 329 patients and there was no conversion to open surgery. CONCLUSION: Even though the LADG was accompanied by a difficult learning curve, we successfully performed 329 LADG procedures over the past 2 years and we believe that LADG is a safe, feasible operation for treating most early gastric cancers (EGC).
