Abstract Nguyen Vu Tuan Anh

EARLY RESULTS OF TOTALLY LAPAROSCOPIC NEAR TOTAL GASTRECTOMY FOR GASTRIC CANCER MANAGEMENT

Anh Nguyen Vu Tuan, Bac Nguyen Hoang, Hai Nguyen Viet, Quoc Ho Le Minh, Dat Tran Quang, Thong Dang Quang, Long Vo Duy

Upper Gastro-intestinal Surgery Department, University Medical Center, Hochiminh city, Vietnam

Abstract

Background

Laparoscopic distal gastrectomy for gastric cancer has accepted and widely used all over the world. However, even experienced surgeons, totally laparoscopic near total gastrectomy for gastric cancer still suffered some challenges and controvesies among surgeons around the world, althrough gaining strength in the several recent decades, especially in lymphadenectomy and reconstruction. In Viet Nam, there’re still no any researchs about totally laparoscopic near total gastrectomy and lymphadenectomy for gastric cancer, especially the middle third stomach tumors.

Objectives

To describe the results from the clinical and anatomopathological point of view and early results in totally laparoscopic near total gastrectomy and D2 lymphadenectomy for gastric cancer

Method

This is a prospective study. Analyses data from patients submitted to totally laparoscopic near total gastrectomy and D2 limphadenectomy. The data of 40 patients showed have been submitted to laparoscopic near total gastrectomy from Jan 2018 to May 2019. The clinical datas and surgical outcomes is evaluated.

Results

40 patients underwent totally laparoscopic near total gastrectomy and D2 lymphadenectomy, The average operation time is 224,5 minutes (range, 150 to 360 minutes), the average anastomosis time is 32 minutes (range, 15 to 50 minutes), the average blood loss is 25,6 ml (range, 10 to 90ml). No case dued to any internal operating complication. There were no deaths, and morbidity rate was 4%, including one developed pneumo pleural effusion, and one developed surgical site infection. The average hospital stay is 7,8 days (range, 5 to 14 days). No case dued to leakage of gastrojujinostomy and duodenal stump.

Conclusions

Laparoscopic near total gastrectomy for gastric cancer is safe, feasible. Furthermore, it is also reliable in patients with middle third, and even upper third gastric cancers, and could be routinely applied.

Keyword

Totally laparoscopic near total gastrectomy, gastric cancer, lymphadenectomy, subtotal gastrectomy, distal subtotal gastrectomy, subtotal gastrectomy with very small remnant stomach.