Comparative Study of Laparoscopy-Assisted Distal Gastrectomy and Open Distal Gastrectomy

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Abstract
Most studies comparing surgical results of laparoscopic procedures for gastric cancer with open gastrectomies have been conducted based on limited experience. We aimed to compare laparoscopy-assisted distal gastrectomy (LADG) and conventional open distal gastrectomy (ODG) after a protracted learning experience. We retrospectively reviewed medical records data. Two hundred fifty six patients underwent distal gastrectomies (136 LADG, 120 ODG). There were 150 early gastric cancer (EGC) patients (120 LADG, 30 ODG). Mean operation times for LADG and ODG were similar among EGC (156.5 versus 159.3 minutes, p = 0.666). Mean retrieved lymph node counts for LADG and ODG were different, but were > 30 (31.3 versus 40.4 for all and 30.4 versus 38.1 for EGC). For all subjects or EGC patients after LADG, C-reactive proteins on day 5 were substantially lower, first liquid diet was resumed substantially sooner, and postoperative hospital stays were substantially shorter than for ODG. LADG with lymph node dissection after a learning curve has several advantages compared with ODG, namely, less inflammatory reaction, rapid return of gastrointestinal function, and shorter hospital stay without compromising operation time or operative curability.