Video-assisted surgery in gastric cancer

RESUMEN

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ABSTRACT

Introduction. The present study presents the initialresults of the use of video-assisted surgery in thecurative intent treatment of gastric cancer in a specialisedunit of esophago-gastric pathology.Methods. Since December 2002 we have substitutedlaparotomy for video-assisted surgery for the surgicaltreatment of gastric cancer. We report our initialexperience in 28 patients. In 20 we performed a totalgastrectomy with Roux Y esophago-jejunum reconstruction.In another 8 cases we performed subtotalgastrectomy with Roux Y reconstruction. Theanastomoses in total gastrectomy were performedwith laparoscopy with the EEA head descendingvia the endo-esophageal route. The resected piece isextracted via minimum laparotomy. The associatedcomplete lympadenectomy D2 was performed inthe tumours of the gastric antrum and D1 plus thelymph node groups 7, 8, 9 and proximal 11 at thesecond level in the gastric body and fundus.Results. The mean duration of intervention was 222minutes and the mean blood loss was 185 ml. Mortalitywas 3.7% and morbidity was 19%. There was areduction in post-operative analgesia requirementsand the mean hospital stay was 11 days.Conclusions. Gastric resection and related lympadenectomycan be performed using video-assistedsurgery in a manner that is as safe as conventionalsurgery and, further, has considerable advantages.The greater complexity requires that the surgicalteam is better trained in the use of the laparoscopytechnique. In the few studies on the theme, thereappears to be no oncological inconveniences associatedwith the technique