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Laparoscopy-Assisted Distal Gastrectomy Versus Open Distal Gastrectomy. A Prospective Randomized Single-Blind Study.
MedLine Citation:
PMID:  23783252     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Laparoscopy-assisted distal gastrectomy (LADG) is generally considered superior to open distal gastrectomy (ODG) with regard to postoperative quality-of-life. Differences in postoperative pain may exist due to recent pain control techniques including epidural anesthesia. There is little evidence for this difference. In this article we report the results of our randomized single-blind study in LADG versus ODG. The aim of the present study was to evaluate differences in postoperative physical activity between LADG and ODG. METHODS: Forty patients with early gastric cancer (stage IA and IB) were registered in this randomized study. For strict evaluation, patients were not told about the type of operation until postoperative day 7. Postoperative physical activity was evaluated objectively by Active Tracer, which records the cumulative acceleration over a 24 h period to investigate differences in postoperative recovery. Questionnaire and visual analog scale score related to postoperative pain were also investigated. RESULTS: Significant differences were observed with a more favorable outcome noted in the LADG group with respect to intraoperative blood loss (P < 0.001), total amount of pain rescue (P < 0.001), wound size (P < 0.001), postoperative hospital stay (P < 0.001), and inflammatory parameters (C-reactive protein, SaO2, and duration of febrile period) (P < 0.001). Cumulative physical recovery to 70 % of the preoperative level was significantly shorter (by 3 days, P < 0.001) in the LADG group. CONCLUSIONS: Comparison of LADG and ODG for patients with early gastric cancer showed favorable outcome and earlier recovery of physical activity in the LADG group.
Authors:
Shuji Takiguchi; Yoshiyuki Fujiwara; Makoto Yamasaki; Hiroshi Miyata; Kiyokazu Nakajima; Mitsugu Sekimoto; Masaki Mori; Yuichiro Doki
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-6-20
Journal Detail:
Title:  World journal of surgery     Volume:  -     ISSN:  1432-2323     ISO Abbreviation:  World J Surg     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-6-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Osaka University, 2-2 E2 Yamadaoka, Suita, Osaka, 565-0876, Japan, stakiguchi@gesurg.med.osaka-u.ac.jp.
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