Int J Med Sci 2013; 10(11):1462-1470. doi:10.7150/ijms.6632

Research Paper

Totally Laparoscopic Distal Gastrectomy with D2 Lymphadenectomy and Billroth II Gastrojejunostomy for Gastric Cancer: Short- and Medium-term Results of 139 Consecutive Cases from a Single Institution

Ke Chen*, Xiaowu Xu*, Yiping Mou, Yu Pan, Renchao Zhang, Yucheng Zhou, Di Wu, Chaojie Huang

Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Institute of Micro-invasive Surgery, Zhejiang University, Hangzhou, China
* Ke Chen and Xiaowu Xu contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.
Citation:
Chen K, Xu X, Mou Y, Pan Y, Zhang R, Zhou Y, Wu D, Huang C. Totally Laparoscopic Distal Gastrectomy with D2 Lymphadenectomy and Billroth II Gastrojejunostomy for Gastric Cancer: Short- and Medium-term Results of 139 Consecutive Cases from a Single Institution. Int J Med Sci 2013; 10(11):1462-1470. doi:10.7150/ijms.6632. Available from http://www.medsci.org/v10p1462.htm

File import instruction

Abstract

Objective: The goal of this study was to investigate the feasibility, safety, and associated 3-year survival outcomes of the totally laparoscopic distal gastrectomy (TLDG) for the treatment of gastric cancer.

Methods: Herein, we analyzed the clinical data from 139 consecutive patients with gastric cancer who received TLDG at our institution from March of 2007 to March of 2013.

Results: TLDG was successfully carried out in 139 patients; no cases were converted to open surgery. The mean operation time was 228.6 ± 51.0 minutes, mean blood loss was 131.2 ± 85.2 mL, and mean number of dissected lymph nodes was 31.1 ± 9.0. The average time to flatus, time to fluid diet, and length of hospital stay were 3.6 ± 1.1 days, 4.8 ± 1.6 days, and 9.8 ± 4.0 days, respectively. The postoperative morbidity was 10.1%. A total of 135 patients were followed for a subsequent 1-73 months (median, 24.0 months). The 3-year disease-free survival (DFS) and overall survival (OS) rates were 82.3% and 82.9%, respectively. When divided by stage, the 3-year DFS for stage I, II, and III were 100%, 86.2%, and 48.8%, respectively; and the 3-year OS for stage I, II, and III were 98.0%, 92.3%, and 51.6%, respectively.

Conclusions: In this preliminary report, TLDG was found to be a safe, feasible, and efficacious procedure for the treatment of gastric cancer with encouraging 3-year overall and stage-by-stage survival rates.

Keywords: laparoscopy, gastric cancer, clinical study, survival