Indications and Curability of Laparoscopy Assisted Distal Gastrectomy

Norio Shiraishi, Yosuke Adachi, Akio Morimoto, Kohichi Sato, Seigo Kitano

First Department of Surgery, Oita Medical University School of Medicine

Laparoscopic surgery is now widely acceped because it has resulted in redused pain, early discharge, and good cosmesis. Thirty-six patients with early-stage gastric cancer were treated by laparoscopyassisted distal gastrectomy (LADG). To clarify the accuracy and problems of the present indications for LADG, we examined the reasons for select of LADG, the precision of the depth diagnosis before the operation, and of the histological depth examinations. Sixty-two percent of the LADGs were selected because the lesions were mucosal cancers with large size or ulceration. The accuracy of the preoperative depth diagnosis was 91% for mucosal carcinomas and 50% for submucosal carcinomas. Histological examination revealed that only 3 submucosal cancers had regional lymph node metastasis (n1). Because LADG dissected regional lymph nodes, all patients received the operation with high probability of a cure. These results show that for the present indications LADG is suitable and safe. We need more study of preoperative depth diagnosis of mucosal carcinomas with ulceration and submucosal carcinomas to expand the indications for LADG.

Key words
early gastric cancer, laparoscopic surgery, laparoscopy assisted distal gastrectomy

Reprint requests
Norio Shiraishi First Department of Surgery, Oita Medical University School of Medicine
1-1 Idaigaoka, Hasama-cho, Oita-gun, Oita, 879-5503 JAPAN

Accepted
December 3, 1997

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