Laparoscopy-assisted distal gastrectomy versus open distal gastrectomy. A prospective randomized single-blind study

Area of Science:

• Gastroenterology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Laparoscopy-assisted distal gastrectomy (LADG) is often preferred over open distal gastrectomy (ODG) for improved quality of life.
• Evidence comparing postoperative pain and recovery between LADG and ODG, particularly with modern anesthesia, is limited.
• This study investigates differences in postoperative physical activity and pain between LADG and ODG.

Purpose of the Study:

• To compare postoperative physical activity between LADG and ODG.
• To evaluate differences in pain and recovery metrics following these two surgical approaches for early gastric cancer.

Main Methods:

• A randomized single-blind study involving 40 patients with early gastric cancer (Stage IA and IB).
• Patients were blinded to their surgical group until postoperative day 7.
• Objective assessment of physical activity using an Active Tracer device, alongside pain questionnaires and visual analog scale scores.

Main Results:

• LADG group showed significantly better outcomes: reduced intraoperative blood loss, less pain medication required, smaller wound size, shorter hospital stay, and improved inflammatory markers.
• Physical recovery to 70% of preoperative levels was achieved 3 days sooner in the LADG group.
• All observed differences were statistically significant (P < 0.001).

Conclusions:

• Laparoscopy-assisted distal gastrectomy (LADG) offers a more favorable outcome compared to open distal gastrectomy (ODG) for early gastric cancer.
• LADG facilitates earlier recovery of physical activity.
• These findings support LADG as a superior surgical option for selected early gastric cancer patients.