[Laparoscopic subtotal gastrectomy -- our experience]

Laparoscopic surgery gained significant popularity in the last two decades. In our department, laparoscopic gall bladder, hernia and large bowel surgeries are the most frequent ones. Recently we started to do laparoscopic surgery for early gastric cancer, too. Initially, wedge resections, distal gastrectomy and laparoscopically asssisted periventricular lymphadenectomies were carried out. Later on, laparoscopic subtotal gastrectomy was also done. Therefore, we can provide three different ways of surgical treatment for gastric malignancies by now: wedge resection, intramucosal resection as well as subtotal gastrectomy. Four laparoscopic gastrectomies were carried out with D1 or D2 lypmhadenectomy - in case it was needed - in our department by the end of 2010. All patients' gastric cancer was less than 3 cm in size, and it was verified by preoperative histology (adenocarcinoma, T1b/N0/M0 or T2/N0/M0). The cancers were localized in the antrum or distally in the peripyloric region, and were ulcerated frequently. Subtotal gastrectomy with retrocolic gastroentero anastomosis was carried out in every case.Patient's age was not considered in patient selection. Surgical time was between two and four hours. We discuss our experience with laparoscopic gastric surgery and recommend its incorporation into practice.