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Laparoscopic Radical Gastrectomy for Remnant Gastric Cancer
Published on: October 31, 2025
Laparoscopy-assisted gastrectomy for patients with earlier upper abdominal open surgery
Masanori Tokunaga1, Naoki Hiki, Tetsu Fukunaga
1Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|February 23, 2010
Summary
Laparoscopy-assisted gastrectomy (LAG) is feasible in patients with prior open abdominal surgery (EUAOS). Experienced surgeons can safely perform LAG, with minimal complications despite technical challenges of adhesiotomy.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Laparoscopy-assisted gastrectomy (LAG) offers advantages over open gastrectomy.
- Safety of LAG in patients with earlier upper abdominal open surgery (EUAOS) is uncertain due to difficult laparoscopic adhesiotomy.
Purpose of the Study:
- To evaluate the feasibility and safety of performing LAG in patients with a history of EUAOS.
Main Methods:
- Retrospective analysis of 32 consecutive patients with EUAOS who underwent LAG.
- Data collected included operation time, blood loss, conversion rates, and postoperative outcomes.
Main Results:
- Common prior surgery was cholecystectomy. Mean operation time was 256.5 minutes, with 80.7 mL blood loss.
- One conversion to open surgery occurred due to severe adhesions; one incidental perforation was managed laparoscopically.
- No other complications directly related to adhesiotomy were observed.
Conclusions:
- Earlier upper abdominal open surgery (EUAOS) is not a contraindication for laparoscopy-assisted gastrectomy (LAG).
- Successful LAG in these patients depends on the surgeon's laparoscopic expertise.
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