First experiences with laparoscopic assisted distal gastrectomy: in the view of comparison with high volume centers

Recently, the number of laparoscopic gastric surgeries increased in Korea. But since many patients prefer to attend larger hospitals, most operations have been performed in high volume center by experienced surgeons, and also most reported studies on laparoscopic gastric surgery have been performed in these hospitals. For better health service and increased access of local residents, district hospitals that have a smaller number of surgical cases also need to perform this surgery safely.

We retrospectively analyzed 58 patients who underwent laparoscopic assisted distal gastrectomy (LADG) from April 2009 to January 2012 in Dankook University Hospital. We compared our data with the retrospective data of the Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS) group because we thought the KLASS study was a representative study of LADG.

A total of 58 patients underwent LADG during a period of 32 months. The male to female ratio, mean age and body mass index were 34:19, 62.4 years and 23.0 kg/m(2), respectively. More than D1 + β lymph node was dissected in all patients and the mean number of harvested lymph nodes was 31.4. Mean operation time, estimated blood loss and mean hospital stays were 235 minutes, 176 mL and 7.4 days respectively. During the operation, there were no complication and no conversions to open surgery. After the operation, there were 2 cases of wound complication and 1 case of intra-abdominal abscess which improved with conservative treatment and there was no mortality. These data were not different to the data of high volume centers, especially KLASS.

We report first experience with LADG and concluded that LADG could be performed safely in smaller scale hospitals.