World Journal of Laparoscopic Surgery

Register      Login

VOLUME 6 , ISSUE 3 ( September-December, 2013 ) > List of Articles

RESEARCH ARTICLE

Laparoscopy: A Procedure no less than Laparotomy for Lymph Node Dissection in Total Gastrectomy for Gastric Carcinoma

Manash Ranjan Sahoo, T Anil Kumar, Manoj Gowda

Citation Information : Sahoo MR, Kumar TA, Gowda M. Laparoscopy: A Procedure no less than Laparotomy for Lymph Node Dissection in Total Gastrectomy for Gastric Carcinoma. World J Lap Surg 2013; 6 (3):111-115.

DOI: 10.5005/jp-journals-10033-1194

Published Online: 01-04-2016

Copyright Statement:  Copyright © 2013; The Author(s).


Abstract

Aim

To show that laparoscopic lymph node dissection and harvesting is equal to laparotomic lymph node dissection in patients undergoing total gastrectomy for gastric carcinoma.

Materials and methods

Retrospective data was collected from 36 patients who underwent total gastrectomy for carcinoma stomach. Fifteen patients underwent open total gastrectomy (OG) and other 21 laparoscopic assisted total gastrectomy (LAG) over a period of 4 years from March 2009 to June 2012. In the laparoscopic group, dissection of lymph nodes and division of ligaments and omentum was done laparoscopically using harmonic scalpel. Both groups were compared for operative blood loss, operative time, blood transfusion, morbidity, mortality, the number of harvested lymph nodes (HLNs) with emphasis on harvested lymph nodes.

Results

There were no significant differences in morbidity or mortality in both groups. Tumor free margins were obtained in all cases. Compared with OG group, the LAG group had significantly less blood loss, but a longer operation time. The mean harvested lymph nodes (HLN's) is 24.7 in LAG group as compared 23.3 in OG group.

Conclusion

Laparoscopic dissection and harvested lymph nodes is equivalent to OG with no other significant differences except for decreased blood loss and increased operative time. Thus, this procedure can achieve the same result as OG.

How to cite this article

Kumar TA, Gowda M, Sahoo MR. Laparoscopy: A Procedure no less than Laparotomy for Lymph Node Dissection in Total Gastrectomy for Gastric Carcinoma. World J Lap Surg 2013;6(3):111-115.


PDF Share
  1. Patterns of cancer incidence, mortality and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 2006 May;24(14):2137-2150.
  2. Estimates of worldwide burden of cancer in 2008: Globocan 2008. Int J Cancer 2010 Dec;127(12):2893-3917.
  3. Estimates of cancer incidence in China for 2000 and projections for 2005. Cancer Epidemiol Biomarkers Prev 2005;14:243-250.
  4. Gastric cancer in Korea. Gastric Cancer 2002;5:177-182.
  5. Laparoscopic surgery for gastric cancer: 5 years' experience. J Nihon Med Sch 2006 Aug;73(4):214-220.
  6. The technique of laparoscopic Billroth II gastrectomy. Surg Laparosc Endosc 1992 Sep;2(3):258-260.
  7. Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer. Br J Surg 2007 Feb;94(2):204-207.
  8. Laparoscopy-assisted total gastrectomy for gastric cancer: a multicenter retrospective analysis. Surgery 2009 Sep;146(3):469-474.
  9. Long-term oncologic outcomes from laparoscopic gastrectomy for gastric cancer: a single-center experience of 601 consecutive resections. J Am Coll Surg 2010 Jul;211(1):33-40.
  10. T-lymphocyte subsets and Th1/Th2 balance after laparoscopyassisted distal gastrectomy. Surg Endosc 2003 Sep;17(9):1440-1444.
  11. A randomized controlled trial comparing open vs laparoscopyassisted distal gastrectomy for the treatment of early gastric cancer: an interim report. Surgery 2002 Jan;131(1 Suppl):S306-S311.
  12. A prospective randomized study comparing open vs laparoscopy-assisted distal gastrectomy in early gastric cancer: early results. Surg Endosc 2005 Feb;19(2):168-173.
  13. Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancer. Surg Endosc 2005 Sep;19(9):1172-1176.
  14. Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg 2005 Feb;241(2):232-237.
  15. Improved quality of life outcomes after laparoscopyassisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg 2008 Nov;248(5):721-727.
  16. Laparoscopy-assisted total gastrectomy with extended lymph node resection for advanced gastric cancer-reports of 82 cases. Hepatogastroenterology 2010 Nov;57(104):1589-1594.
  17. Laparoscopy-assisted D2 radical distal gastrectomy for advanced gastric cancer. Dig Surg 2010;27(4):291-296.
  18. A phase-II clinical trial of laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer patients. Ann Surg Oncol 2007 Nov;14(11):3148-3153.
  19. Feasibility of laparoscopic gastrectomy with radical lymph node dissection for gastric cancer: from a viewpoint of pancreas related complications. Surgery 2011 Jan;149(1):15-21.
  20. The difference in gastric cancer between Japan, USA and Europe: what are the facts? What are the suggestions? Crit Rev Oncol Hematol 2001 Oct;40(1):77-94.
  21. Patient survival after D1 and D2 resections for gastric cancer: long-term results of the MRC randomized surgical trial. Surgical Cooperative Group. Br J Cancer 1999 Mar;79(9-10):1522-1530.
  22. Extended lymph node dissection for gastric cancer: who may benefit? Final results of the randomized Dutch gastric cancer group trial. J Clin Oncol 2004 Jun;22(11):2069-2077.
  23. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol 2010 May;11(5):439-449.
  24. Morbidity and mortality after D1 and D2 gastrectomy for cancer: Interim analysis of the Italian Gastric Cancer Study Group (IGCSG) randomised surgical trial. Eur J Surg Oncol 2004 Apr; 30(3):303-308.
  25. Survival results of a multicentre phase II study to evaluate D2 gastrectomy for gastric cancer. Br J Cancer 2004 May;90(9):1727-1732.
  26. Role of the extended lymphadenectomy in gastric cancer surgery: experience in a single institution. Ann Surg Oncol 2003 Apr;10(3):219-226.
  27. Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer: early and long-term results of a 100-patient series. Am J Surg 2007 Dec;194(6):839-844;discussion 844.
  28. Total and subtotal laparoscopic gastrectomy for adenocarcinoma. Surg Endosc 2007 Jan;21(1):21-27.
  29. Outcomes and survival after laparoscopic gastrectomy for adenocarcinoma. Analysis on 65 patients operated on by conventional or robot-assisted minimal access procedures. Eur J Surg Oncol 2009 Mar;35(3):281-288.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.