Document Detail


Laparoscopic gastrectomy for gastric cancer.
MedLine Citation:
PMID:  19851265     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Surgery in gastric cancer (GC) aims to achieve resection of the primary tumor and its lymphatic drain, with a minimal adverse effect on morbidity and mortality, and the best possible quality of life.
METHODS: From June 1993 to May 2008, 113 patients with a preoperative diagnosis of the GC were considered for laparoscopic gastrectomy at our institution. There was a predominance of males and mean age was 60 years. After peritoneal cavity inspection, laparoscopic ultrasound was used to determine the presence of deep liver metastasis. Total gastrectomy and Roux-en-Y reconstruction were performed in upper and middle-third tumors, and subtotal gastrectomy, either with Billroth II or Roux-en-Y reconstruction, in tumors affecting the lower third of the stomach. D2 lymphadenectomy was performed in both cases.
RESULTS: There were 21 cases (18.5%) with distant metastases and/or an unresectable tumor due to the invasion of adjacent organs. In these patients the procedure was limited to laparoscopic biopsy in 16 cases and laparoscopic gastrojejunostomy in 5 cases. Laparoscopic gastrectomy was performed in 92 patients with a mean surgical time of 162 minutes and a mortality rate of 5.4%. Conversion was necessary in 7 cases (7.6%).
CONCLUSIONS: The benefits and safety of laparoscopic gastrectomy are evident, with similar outcomes to conventional surgery and all the advantages of minimally invasive access. The learning curve is long. Laparoscopic gastrectomy is a safe and effective option for the treatment of GC, avoiding nontherapeutic laparotomy in patients with advanced disease. Comparative prospective studies evaluating the long-term survival of these patients are still necessary.
Authors:
Renam C Tinoco; Augusto C A Tinoco; Luciana J El-Kadre; Daniela M Sueth; Lauro M Conde
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical laparoscopy, endoscopy & percutaneous techniques     Volume:  19     ISSN:  1534-4908     ISO Abbreviation:  Surg Laparosc Endosc Percutan Tech     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-23     Completed Date:  2011-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888751     Medline TA:  Surg Laparosc Endosc Percutan Tech     Country:  United States    
Other Details:
Languages:  eng     Pagination:  384-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, Hospital São José do Avaí, Brazil. el-kadre@uol.com.br
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anastomosis, Roux-en-Y
Brazil
Duodenum / surgery
Female
Gastrectomy / methods*
Gastroenterostomy
Humans
Laparoscopy / methods*
Lymph Node Excision / instrumentation,  methods
Male
Middle Aged
Omentum / surgery
Reoperation / statistics & numerical data
Stomach Neoplasms / mortality,  surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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