Laparoscopy-assisted radical subtotal gastrectomy for early gastric carcinoma

In order to evaluate whether it is possible to perform a minimal invasive operation without compromising to the radicality, we analyzed six patients who had been performed laparoscopy-assisted radical subtotal gastrectomy at Yongdong Severance Hospital, Yonsei University College of Medicine between September 1995 and February 1996. All patients were diagnosed as early gastric carcinoma without lymph node metastases preoperatively by upper gastrointestinal barium study (UGI), esophagogastroduodenoscopy (EGD) with biopsy and computed tomography scan (CT-scan). Postoperative pathologic reports revealed that we could obtain the resection margin and regional lymph nodes sufficient enough by laparoscopy-assisted radical subtotal gastrectomy. All patients had a good postoperative course. Flatus was present on the 2nd in a patient and 3rd postoperative day in five patients respectively. Nasogastric tube was removed and oral feeding was started on the day after flatus was present. Minor bile leak was noted in one patient postoperatively and managed conservatively. The postoperative scar was in excellent condition and measured about 2 approximately 3 inches in length. And postoperative courses were uneventful in all except a patient with bile leakage. Further technical experience and development could shorten the operation time. Popular acceptance of this procedure in the management of early gastric carcinoma (EGC) may give great help to the patients.