Open Access, Peer-reviewed
pISSN 2288-6575
eISSN 2288-6796
    J Korean Surg Soc. 2010 Oct;79(4):281-286. Korean.
    Published online Oct 31, 2010.
    https://doi.org/10.4174/jkss.2010.79.4.281
    Copyright © 2010 The Korean Surgical Society
    Original Article

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

    Jooyoung Song, M.D., Ki Han Kim, M.D., Ph.D., Young Hun Roh, M.D., Ph.D., Min-Chan Kim, M.D., Ph.D., Hong-Jo Choi, M.D., Ph.D. and Ghap-Joong Jung, M.D., Ph.D.
      • Department of Surgery, Dong-A University College of Medicine, Busan, Korea.
    • Corresponding author (Email: sshamee@dau.ac.kr )
    Received April 26, 2010; Accepted June 17, 2010.

    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.

    Keywords
    Multiple early gastric cancer; Laparoscopy; Robot

    Tables

    Table 1
    Clinicopathological features in open gastrectomy and laparoscopy or robot assisted gastrectomy

    Table 2
    Location and number of main and accessory lesions of multiple early gastric cancer in open gastrectomy and laparoscopy or robot assisted gastrectomy

    Table 3
    Postoperative outcomes, recurrence and survival of multiple early gastric cancer

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