TY  - JOUR
T1  - LAparoscopic total gastrectomy with d2 lymph node dissection for gastric cancer
AU  - Shinohara T, Kanaya S, Taniguchi K, Fujita T, Yanaga K, Uyama I
Y1  - 2009/12/21
N1  - 10.1001/archsurg.2009.223
JO  - Archives of Surgery
SP  - 1138
EP  - 1142
VL  - 144
IS  - 12
N2  - Objective 
    To evaluate the safety and effectiveness of laparoscopic total gastrectomy with D2 lymphadenectomy for gastric cancer.Design 
    Review of findings from a prospectively acquired institutional database.Setting 
    University hospital.Patients 
    Fifty-five consecutive patients operated on by the same surgeon between October 1997 and March 2008.Main Outcome Measures 
    Blood loss, complication rate, and survival.Results 
    All operations were accomplished without conversion to open laparotomy. The median operative time was 406 minutes. The median blood loss was 102 mL. A median of 46 lymph nodes were harvested. The TNM stages of the tumor were I in 17 patients (31%), II in 12 (22%), III in 16 (29%), and IV in 10 (18%). A total of 21 complications occurred in 18 patients (33%) with no postoperative mortality. At last follow-up, 44 of the 55 patients were alive without tumor recurrence and 3 with recurrence at a median follow-up of 16 months, whereas 8 had died of recurrence or another cause.Conclusions 
    The mortality rate of zero and acceptable morbidity of our series indicate that laparoscopic total gastrectomy with D2 lymphadenectomy is technically feasible and safe in the hands of experienced surgeons. Long-term follow-up is mandatory to validate oncologic outcome.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.2009.223
UR  - http://dx.doi.org/10.1001/archsurg.2009.223
ER  -