Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancer

Surg Endosc. 2005 Sep;19(9):1172-6. doi: 10.1007/s00464-004-8207-4. Epub 2005 Jul 28.


Background: Laparoscopy-assisted surgery with extraperigastric lymph node dissection for gastric cancers has been described, but the clinical benefits of these surgeries still are unclear. Short-term clinical outcomes were compared between laparoscopy-assisted distal gastrectomy (LADG) and conventional open distal gastrectomy (ODG) for early gastric cancer in a prospective randomized fashion.

Methods: For this study, 28 patients with early gastric cancers in the lower half of the stomach were randomly assigned to either LADG (n = 4) or ODG (n = 14). Postoperative pain, levels of acute inflammatory responses, and pathologic evaluation of the operative specimens were compared.

Results: The LADG group required a significantly shorter period of postoperative epidural anesthesia, showed significantly lower levels of serum interleukin-6 and C-reactive protein, and had no major postsurgery complications. Pathologic examinations showed that surgery was equally radical in the two groups.

Conclusion: The findings show that LADG with extraperigastric lymph node dissection is a safe and less invasive alternative to the open procedure.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Female
  • Gastrectomy / methods*
  • Humans
  • Laparoscopy*
  • Lymph Node Excision / methods*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Prospective Studies
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*