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Ten Cases of Laparoscopic Total Gastrectomy for Remnant Gastric Cancer

Daisuke Azuma, Masaki Fukunaga, Kunihiko Nagakari, Seiichiro Yosikawa, Yosihito Iida, Masakazu Ouchi, Kazuhiro Takehara, Knnpei Honjyo, Yuu Gyouda, Shintaro Kohama, Jun Nomoto, Hirotaka Momose. Department of Surgery, Juntendo Urayasu Hospital, Juntendo University

Background: Laparoscopic total gastrectomy for remnant gastric cancer is much more difficult than common Laparoscopic total gastrectomy due to severe adhesions to adjacent organs, displacement of anatomical structure.

Purpose: The aim was to analyze 10 cases of Laparoscopic total gastrectomy for remnant gastric cancer at the Department of Surgery of Juntendo University Urayasu Hospital between November 1999 and April 2017.

Method: We analyzed outcome and feasibility of Laparoscopic total gastrectomy surgery for remnant gastric cancer. And we compared with laparoscopic total remnant gastrectomy (10 cases) versus Laparoscopic total gastrectomy (101 cases) in our hospital.

Results: In the previous laparoscopic surgeries We performed laparoscopic distal gastrectomy in 5 cases, laparoscopic proximal gastrectomy in 2 pcases, and open distal gastrectomy in 3 cases. 

All cases were performed laparoscopic total gastrectomy with R-Y reconstruction. 1 case of them had been converted to open surgery due to severe adhesions.

The mean operative time was 271 min and the mean blood loss was 189 ml. There were no intra-operative complications, and there were 2 postoperative complications as a pancreatic fistula and a bowel obstruction. However, there were no intra-operative complications more than Grade 3 according to the Clavien-Dindo classification. The mean postoperative hospital stay was 22.4 days. All cases were without recurrence.

Thus, there were no significant differences in operative time, bleeding volumes, intra and postoperative complications and hospital stay compared with Laparoscopic total gastrectomy.

Conclusions: Laparoscopic total remnant gastrectomy can be performed with similar short-term outcomes to Laparoscopic total gastrectomy, and may be feasible and safe procedure, and can become an option of therapeutic strategy.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87664

Program Number: P423

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

41

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