PMID- 29631903 OWN - NLM STAT- MEDLINE DCOM- 20190307 LR - 20190307 IS - 0929-6646 (Print) IS - 0929-6646 (Linking) VI - 118 IP - 1 Pt 1 DP - 2019 Jan TI - Laparoscopic distal gastrectomy for clinical stage I gastric adenocarcinoma: Techniques evolution and oncological outcomes of the first 100 cases. PG - 179-185 LID - S0929-6646(17)30669-1 [pii] LID - 10.1016/j.jfma.2018.03.010 [doi] AB - BACKGROUND/PURPOSE: While gaining more acceptance, the use of laparoscopic distal gastrectomy (LDG) to treat gastric cancer were still limited in Taiwan. This study reviewed our experience about the technique evolution and outcome of using LDG for the patients with clinical stage (c-stage) I gastric cancers. METHODS: A retrospective review of the patients undergoing LDG for c-stage I gastric cancers at a medical center of Taiwan was performed. The demographics, peri-operative parameters, reconstruction methods, morbidities, pathologic and oncological outcomes were analyzed. RESULTS: A total of 100 patients with c-stage I gastric cancers between October 2005 and September 2016 were enrolled. Laparoscopy-assisted distal gastrectomy (LADG) was performed in the initial 69 cases. Total laparoscopic distal gastrectomy (TLDG) was done in the following 31 cases. There was no conversion of procedures, nor surgical mortality. The surgical morbidity rate was 13%, including 3 major complications. The ratio of using Billroth I reconstruction (83.9% versus 43.5%, p < 0.01) and the mean number of harvested lymph nodes (38.6 +/- 14.8 versus 31.2 +/- 15.2, p = 0.02) were both higher in the TLDG group than in the LADG group. The pathologic examination confirmed 78 patients were stage I, while 22 were stage II disease. Seven of the 24 patients with lymph node metastasis received adjuvant chemotherapy. Two patients had recurrence of diseases. The 3-year recurrence-free and overall survival were 93.3% and 95.8% separately. CONCLUSION: These results suggested that laparoscopic gastrectomy could be performed safely and feasibly for patients with early gastric cancers. LADG is recommended for the establishment of the demanding technique. CI - Copyright (c) 2018. Published by Elsevier B.V. FAU - Yeh, Chi-Chuan AU - Yeh CC AD - Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan; Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan. FAU - Yen, Hung-Hsuan AU - Yen HH AD - Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. FAU - Lai, I-Rue AU - Lai IR AD - Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: iruelai@gmail.com. LA - eng PT - Comparative Study PT - Journal Article DEP - 20180407 PL - Singapore TA - J Formos Med Assoc JT - Journal of the Formosan Medical Association = Taiwan yi zhi JID - 9214933 SB - IM MH - Adenocarcinoma/mortality/pathology/*surgery MH - Aged MH - Female MH - Gastrectomy/adverse effects/*methods MH - Gastroenterostomy/adverse effects/*methods MH - Humans MH - Laparoscopy/adverse effects/*methods MH - Lymph Nodes/pathology MH - Lymphatic Metastasis MH - Male MH - Middle Aged MH - Neoplasm Recurrence, Local/etiology MH - Postoperative Complications/etiology MH - Retrospective Studies MH - Stomach Neoplasms/mortality/pathology/*surgery MH - Survival Analysis MH - Taiwan/epidemiology MH - Treatment Outcome OTO - NOTNLM OT - Billroth I OT - Distal gastrectomy OT - Gastric cancer OT - Laparoscopy EDAT- 2018/04/11 06:00 MHDA- 2019/03/08 06:00 CRDT- 2018/04/11 06:00 PHST- 2017/09/21 00:00 [received] PHST- 2018/01/19 00:00 [revised] PHST- 2018/03/13 00:00 [accepted] PHST- 2018/04/11 06:00 [pubmed] PHST- 2019/03/08 06:00 [medline] PHST- 2018/04/11 06:00 [entrez] AID - S0929-6646(17)30669-1 [pii] AID - 10.1016/j.jfma.2018.03.010 [doi] PST - ppublish SO - J Formos Med Assoc. 2019 Jan;118(1 Pt 1):179-185. doi: 10.1016/j.jfma.2018.03.010. Epub 2018 Apr 7.