Short-term and long-term outcomes of laparoscopic pylorus-preserving gastrectomy.

Abstract

181 Background: Distal gastrectomy is still a standard surgical procedure for early gastric cancer locating in the middle third of the stomach. Laparoscopic pylorus-preserving gastrectomy (LPPG) is promising method which can achieve both minimally invasive and function-preserving outcomes; however, the advantage of PPG against laparoscopic distal gastrectomy (LDG) has not been clarified. Methods: This study examined the clinical outcomes of 71 patients who underwent LPPG for cT1 N0 GC located in the middle part of the stomach and 168 patients who underwent LDG with BillrothI reconstruction for cT1 N0 GC located in the middle or lower part of the stomach between September 2006 and December 2014. Surgical outcomes of LPPG were retrospectively compared with those of LDG. Results: The pathological T- and N-stage of the two groups were similar. There was no significant difference in the mean number of resected lymph nodes (37 in LPPG and 33 in LDG). Operation time was longer in LPPG than LDG (248min:LPPG, 228min:LDG) and blood loss were higher in LPPG than LDG (72ml:LPPG, 54ml:LDG). Postoperative hospital stay was longer in LPPG than LDG (13days:LPPG, 11days:LDG). There was no difference in the surgical complications (12.7%:LPPG, 9.5%:LDG) and no mortality occurred(no in-hospital deaths). Only one case of LDG was died of postoperative recurrence. The mean weight loss rate in 3 years after gastrectomy was lower in LPPG than in LDG (7.7% and 10.4%, respectively). Conclusions: LPPG is an acceptable and favorable operative method with possible prevention of weight loss for clinically diagnosed early stage GC.