Comparison of laparoscopy-assisted and totally laparoscopic Billroth-II distal gastrectomy for gastric cancer.
10.4174/jkss.2012.82.3.135
- Author:
Junhyun LEE
1
;
Dongjin KIM
;
Wook KIM
Author Information
1. Department of Surgery, The Catholic University of Korea School of Medicine, Seoul, Korea. kimwook@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Laparoscopic distal gastrectomy;
Extra-corporeal anastomosis;
Intra-corporeal anastomosis;
Billroth-II anastomosis
- MeSH:
Cosmetics;
Demography;
Gastrectomy;
Humans;
Incidence;
Length of Stay;
Stomach Neoplasms
- From:Journal of the Korean Surgical Society
2012;82(3):135-142
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: In laparoscopic distal gastrectomy for gastric cancer, most surgeons prefer extra-corporeal anastomosis because of technical challenges and unfamiliarity with intra-corporeal anastomosis. Herein, we report the feasibility and safety of intra-corporeal Billroth-II anastomosis in gastric cancer. METHODS: From April 2004 to March 2011, 130 underwent totally laparoscopic distal gastrectomy with intra-corporeal Billroth-II reconstruction, and 269 patients underwent laparoscopy-assisted distal gastrectomy with extra-corporeal Billroth-II reconstruction. Surgical efficacies and outcomes between two groups were compared. RESULTS: There were no differences in demographics and clinicopathological characteristics. The mean operation and reconstruction times of totally laparoscopic distal gastrectomy were statistically shorter than laparoscopy-assisted distal gastrectomy (P = 0.019; P < 0.001). Anastomosis-related complications were observed in 11 (8.5%) totally laparoscopic distal gastrectomy and 21 (7.8%) laparoscopy-assisted distal gastrectomy patients, and the incidence of these events was not significantly different. Post-operative hospital stays for totally laparoscopic distal gastrectomy were shorter than laparoscopy-assisted distal gastrectomy patients (8.3 +/- 3.2 days vs. 9.9 +/- 5.3 days, respectively; P = 0.016), and the number of times parenteral analgesic administration was required in laparoscopy-assisted distal gastrectomy patients was more frequent after surgery. CONCLUSION: Intra-corporeal Billroth-II anastomosis is a feasible procedure and can be safely performed with the proper experience for laparoscopic distal gastrectomy. This method may be less time consuming and may produce a more cosmetic result.
