Efficacy of Minilaparotomy for Early Gastric Cancer

ABSTRACT

PURPOSE: Laparoscopic gastrectomy has oncologic unreliability, technical problems, and is expensive. To overcome these drawbacks, we performed operations through a small laparotomy without using a laparoscopic procedure. METHODS: From March to August, 2003, we successfully performed distal gastrectomy with minilaparotomy for 21 patients diagnosed with early gastric cancer in our hospital. An additional 24 patients with advanced gastric cancer underwent conventional laparotomy for distal gastrectomy. We performed distal gastrectomy with lymph node dissection, moving the abdominal window to the surgical site. We compared BMI, operating time, bleeding volume, and postoperative pain, and followed minilaparotomy patients for an average of 48 months. RESULTS: There were no postoperative complications in minilaparotomy patients. The minilaparotomy group had a shorter hospital stay lower analgesic use than conventional laparotomy, but there were no differences in BMI, bleeding volume, or the number of harvested lymph nodes. Minilaparotomy alleviated the severity of postoperative pain, and there were no recurrences during follow-up. CONCLUSION: Minilaparotomy for early gastric cancer improved postoperative outcome without oncologic inadequacy compared with conventional laparotomy. Therefore, distal gastrectomy via a minilaparotomy may become a minimally invasive therapeutic strategy for early gastric cancer.