Minimally Invasive Total Gastrectomy for Gastric Cancer: A Pilot Series

Evelyn L. Kachikwu, Vijay Trisal, Joseph Kim, Alessio Pigazzi, Joshua D.I. Ellenhorn

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

Background: Minimally invasive surgery for select gastrointestinal disease has gained worldwide acceptance. However, laparoscopic total gastrectomy for cancer remains controversial. The purpose of this study was to examine an initial experience with laparoscopic total gastrectomy. Methods: Medical records of 16 consecutive patients who underwent laparoscopic total gastrectomy between September 2007 and December 2009 were reviewed in a retrospective manner. Esophagojejunostomy was completed using a transorally delivered anvil, with double-stapled esophageal anastomosis. Results: There were no conversions to open procedures. Two patients (12.5%) required extended resections with en bloc distal pancreatectomy and splenectomy, one of whom also underwent transverse colectomy. The median lymph node count for patients who underwent D2 lymphadenectomy (n = 12) for gastric adenocarcinoma was 31. There were no perioperative deaths and the median length of stay was 8 days. There were no anastomotic leaks, but three patients developed anastomotic strictures amenable to dilatation. Conclusions: Minimally invasive total gastrectomy can be performed safely and with adequate lymphadenectomy. The procedure provides an excellent short-term outcome with potential for improved patient outcome.

Original languageEnglish
Pages (from-to)81-86
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume15
Issue number1
DOIs
StatePublished - Jan 2011

Keywords

  • Gastric cancer
  • Laparoscopic gastrectomy
  • Total gastrectomy

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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