J Korean Surg Soc.  2012 Sep;83(3):130-134. 10.4174/jkss.2012.83.3.130.

First experiences with laparoscopic assisted distal gastrectomy: in the view of comparison with high volume centers

• Jee YS

• KMID: 2212284
• DOI: http://doi.org/10.4174/jkss.2012.83.3.130

Abstract

PURPOSE
Recently, the number of laparoscopic gastric surgeries increased in Korea. But since many patients prefer to attend larger hospitals, most operations have been performed in high volume center by experienced surgeons, and also most reported studies on laparoscopic gastric surgery have been performed in these hospitals. For better health service and increased access of local residents, district hospitals that have a smaller number of surgical cases also need to perform this surgery safely.
METHODS
We retrospectively analyzed 58 patients who underwent laparoscopic assisted distal gastrectomy (LADG) from April 2009 to January 2012 in Dankook University Hospital. We compared our data with the retrospective data of the Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS) group because we thought the KLASS study was a representative study of LADG.
RESULTS
A total of 58 patients underwent LADG during a period of 32 months. The male to female ratio, mean age and body mass index were 34:19, 62.4 years and 23.0 kg/m2, respectively. More than D1 + beta lymph node was dissected in all patients and the mean number of harvested lymph nodes was 31.4. Mean operation time, estimated blood loss and mean hospital stays were 235 minutes, 176 mL and 7.4 days respectively. During the operation, there were no complication and no conversions to open surgery. After the operation, there were 2 cases of wound complication and 1 case of intra-abdominal abscess which improved with conservative treatment and there was no mortality. These data were not different to the data of high volume centers, especially KLASS.
CONCLUSION
We report first experience with LADG and concluded that LADG could be performed safely in smaller scale hospitals.

Keyword

Stomach neoplasms; Laparoscopy

MeSH Terms

Abdominal Abscess
Body Mass Index
Female
Gastrectomy
Health Services
Hospitals, District
Humans
Korea
Laparoscopy
Length of Stay
Lymph Nodes
Male
Retrospective Studies
Stomach Neoplasms

Figure

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  Fig. 1 Operative time is displayed as a linier-plot and plotted a best fit line using the Loess fit method. The weight function used in the Loess method is the tricube weight function. Horizontal line shows mean operation time of Korean Laparoendoscopic Gastrointestinal Surgery Study.

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