Document Detail

Laparoscopy-assisted pylorus-preserving gastrectomy: preservation of vagus nerve and infrapyloric blood flow induces less stasis.
MedLine Citation:
PMID:  17952497     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pylorus-preserving gastrectomy (PPG) prevents postprandial symptoms; however, delayed gastric retention due to aberrant pylorus function can occur during the early postoperative period. This study aimed to establish a stasis-less PPG procedure with preservation of the vagal nerve and blood flow to the pyloric cuff, and to apply the technique for laparoscopy-assisted PPG. METHODS: Ninety patients with T1 gastric cancer located in the middle third of the stomach were enrolled in this study for surgery from January 2003 to March 2006, undergoing either laparoscopy-assisted PPG (LAPPG; 39 patients) or conventional PPG (CPPG; 51 patients). Operative and early postoperative outcomes were compared between the two groups. RESULTS: Relatively low rates of gastric stasis were observed in both the LAPPG (8%) and CPPG (6%) groups. Estimated blood loss in LAPPG (65.4 +/- 12.3 ml) patients was significantly lower than in the CPPG group (160.7 +/- 19.6 ml) (p < 0.001), and the total number of dissected lymph nodes was significantly greater in the LAPPG group (36.2 +/- 1.8) than in the CPPG group (29.0 +/- 1.3) (p = 0.001). CONCLUSIONS: A PPG procedure with less postoperative stasis and adequate lymph node retrieval was established and applied successfully in laparoscopy-assisted surgery.
Souya Nunobe; Naoki Hiki; Tetsu Fukunaga; Masanori Tokunaga; Shigekazu Ohyama; Yasuyuki Seto; Toshiharu Yamaguchi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  31     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-03-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2335-40     Citation Subset:  IM    
Department of Surgery, Cancer Institute Hospital, Tokyo, Japan.
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MeSH Terms
Gastrectomy / adverse effects*,  methods*
Gastroparesis / physiopathology,  prevention & control*
Lymph Node Excision
Middle Aged
Postgastrectomy Syndromes / prevention & control
Pylorus / blood supply,  physiopathology
Stomach Neoplasms / surgery
Treatment Outcome
Vagus Nerve / physiopathology

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