Author/Authors :
Aktimur, Recep Samsun Education and Research Hospital - Department of General Surgery, Turkey , Cetinkunar, Süleyman Adana Numune Education and Research Hospital - Department of General Surgery, Turkey , Yıldırım, Kadir Samsun Education and Research Hospital - Department of General Surgery, Turkey , Odabaşı, Eylem Samsun Education and Research Hospital - Department of Radiation Oncology, Turkey , Alıcı, Ömer Samsun Education and Research Hospital - Department of Pathology, Turkey , Nigdelioğlu, Adil Samsun Education and Research Hospital - Department of Gastroenterology, Turkey , Özlem, Nuraydın Samsun Education and Research Hospital - Department of General Surgery, Turkey
Abstract :
Objective: Today, minimal invasive surgery has gained wide acceptance by general surgeons, even in complex oncological procedures. Despite the increased experience on laparoscopic distal gastrectomy, limited number of surgeons prefer laparoscopic total gastrectomy for proximal or middle-third gastric cancer, due to the concern of technical difficulties which can alter the quality of oncological outcomes. Methods: We retrospectively analyzed gastric cancer patients who underwent curative intent laparoscopic gastrectomy by single surgeon from October 2013 to April 2014. Five total gastrectomy + D2 (-No 10 and 11d) and 1 distal gastrectomy + D2 lymphadenectomy were analyzed for patient demographics, pathological characteristics, morbidity and in-hospital mortality. Results: The mean operating time was 255,8±37.2 minutes. The mean blood loss was 121.6±20.4 ml. In all patients, R0 resection were performed. The mean number of harvested lymph nodes were 22.6±7.3. The median number of metastatic lymph nodes was 16 (0-23). In one patient, less than 15 lymph nodes were retrieved. Complication rate was 33.3% (n=2). In one patient, who underwent laparoscopic distal gastrectomy, afferent loop syndrome developed. In another patient, who underwent total gastrectomy plus splenectomy a massive pulmoner embolism developed. The median hospital stay was 10(6-18) days. Conclusion: With increased experience in advanced laparoscopic procedures, laparoscopic total gastrectomy may be considered as the first line treatment approach for gastric cancer patient even in a low-volume center.
NaturalLanguageKeyword :
Gastric cancer , Laparoscopic gastrectomy , distal gastrectomy , total gastrectomy
