[Usefulness of Laparoscopic Total Gastrectomy for Remnant Gastric Cancer]

Total gastrectomy for remnant gastric cancer is one of the most difficult procedures in gastric cancer surgery. In our hospital, we have performed laparotomy so far, but in recent years we have shifted to laparoscopic surgery. We verified the safety and usefulness of laparoscopic surgery from the surgical cases in our hospital. We compared the surgical outcomes of 26 patients who underwent laparotomy or laparoscopic total gastrectomy for remnant gastric cancer after 2010. 19 patients had undergone gastrectomy for gastric cancer, and 7 patients had done for benign diseases. In the gastrectomy of remnant gastric cancer, laparotomy was performed in 19 patients and laparoscopic surgery was performed in 7 patients. The laparoscopic group had a long operation time(274 vs 402 min), less bleeding(434 vs 124 mL), more lymph node dissection(11 vs 20 lymph nodes). The rate of postoperative complications(Clavien-Dindo classification more than Grade 2)was low(42.1 vs 28.6%), and the length of hospital stay after surgery was short(14 vs 10 days). No postoperative death was observed in all patients. Conclusion: It was considered that laparoscopic surgery can be safety performed and is a useful surgical procedure for remnant gastric cancer.