J Korean Surg Soc.  2010 Oct;79(4):281-286. 10.4174/jkss.2010.79.4.281.

Is Minimally Invasive Gastrectomy Feasible for the Treatment of Multiple Early Gastric Cancer?

• Song J
• Kim KH
• Roh YH
• Kim MC
• Choi HJ
• Jung GJ

• KMID: 2145030
• DOI: http://doi.org/10.4174/jkss.2010.79.4.281

Abstract

PURPOSE
As preoperative diagnostic tools have advanced, the rate of multiple early gastric cancer diagnoses have increased. The author investigated the clinicopathological features of multiple early gastric cancers to elucidate the clinical feasibility of minimally invasive gastrectomy such as laparoscopy or robot assisted gastrectomy for their surgical treatment.
METHODS
One thousand one hundred and eighty-five open gastrectomies and 607 laparoscopies or robot-assisted gastrectomies for gastric cancers from January 2003 through August 2009 were retrospectively reviewed. Among them, 844 were diagnosed as early gastric cancers, of which 47 cases had multiple early gastric cancers. Twenty-seven cases underwent open gastrectomy and 20 cases underwent laparoscopy or robot assisted gastrectomy. The author analyzed clinicopathological features in these multiple early gastric cancers.
RESULTS
The incidences of multiple early gastric cancers among the early gastric cancers were 5.6%. There were no statistical differences in the clinicopathological parameters except the type of gastrectomy and anastomosis. The distances of both proximal and distal margin show no statistical difference in both groups. The hospital stay was shorter in laparoscopy or robot assisted gastrectomy group (P=0.022). The postoperative complications developed 7 cases in open group and 1 case in laparoscopy or robot assisted gastrectomy group (P=0.046). During the mean follow-up period of 43.8+/-26.4 and 36.2+/-19.8 months, no recurrence was found in both groups.
CONCLUSION
Laparoscopy or robot assisted gastrectomy are as acceptable as open methods to obtain a safe surgical margin, and to perform the desirable type of gastrectomy and radical lymph node dissection.

Keyword

Multiple early gastric cancer; Laparoscopy; Robot

MeSH Terms

Follow-Up Studies
Gastrectomy
Incidence
Laparoscopy
Length of Stay
Lymph Node Excision
Postoperative Complications
Recurrence
Retrospective Studies
Stomach Neoplasms

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