Laparoscopy-assisted Billroth I Gastrectomy Compared with Hand-assisted Laparoscopic Surgery for Early Gastric Cancer -A Prospective Study-.
- Author:
Nam Joon YI
;
Young Woo KIM
;
Ho Seong HAN
- Publication Type:Original Article
- Keywords:
Laparoscopy-assisted Billroth I gastrectomy;
Hand-assisted laparoscopic surgery;
Early gastric cancer
- MeSH:
Conversion to Open Surgery;
Diet, Reducing;
Electrocoagulation;
Female;
Gastrectomy*;
Gastroenterostomy*;
Hand-Assisted Laparoscopy*;
Humans;
Laparoscopy;
Length of Stay;
Leukocyte Count;
Lymph Node Excision;
Lymph Nodes;
Prospective Studies*;
Stomach Neoplasms*;
Ultrasonics;
Wounds and Injuries
- From:Journal of the Korean Surgical Society
2002;62(1):57-63
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To compare standard laparoscopy-assisted Billroth I gastrectomies including standard lymph node dissection (LABIG) with hand-assisted laparoscopic surgery with the HandPort system (HALS) for the removal of early gastric cancers (EGC). METHODS: A prospective study was performed on 26 patients of EGC at Ewha Womans University Mok-Dong Hospital from July 1999 to August 2001. Seventeen patients (Group L) received LABIG using conventional laparoscopy-assisted methods and 9 patients received LABIG using HALS (Group H). We used staplers for the anastomosis, and a standard D2 lymph node dissection was done with ultrasonic shears or electrocautery. RESULTS: In group L, pathologic reports revealed 14 EGC (stage IA 14 cases), and 3 pm cancers (stage IB 1 case, II 2 cases). In group H, there were 9 early gastric cancers (stage IA 8 cases, IB 1 case). Significant differences (P<0.05) were present between group L and H in regards to the number of harvested lymph nodes (30.8 vs 18.9), estimated blood loss (462.1 vs 286.7 ml) and postoperative transfusion amounts (0.59 vs 0 unit). There were no differences in the mean operating time, distance from the lesion to the resection margin, postoperative leukocyte count, frequencies for pain control, wound size, time to diet, weight loss, serum protein, and postoperative hospital stay. Complications were present in 1 case in group L (enterocutaneous fistula) and 1 case in group H (gastric atony). There was one conversion to open surgery in group H. CONCLUSION: LABIG including standard lymph node dissections with both standard laparoscopic surgery and HALS were performed with equal outcome. The choice of surgical method depends on the characteristics of the lesion and the patient's physical factors.
