TITLE:
Laparoscopy Assisted Distal Gastrectomy for Cancer at a Tertiary Center in Egypt. Is It Safe and Feasible?
AUTHORS:
Anwar Tawfik Amin, Ahmed A. S. Salem, Hussein Fakhry, Murad A. Jabir
KEYWORDS:
Gastrectomy, LADG, Laparoscopy, Disposable Instruments
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.8 No.13,
December
14,
2017
ABSTRACT: Background: Laparoscopic radical gastrectomy for
cancer has significant short- and long-term advantages. The feasibility and
safety of laparoscopicdistal gastrectomy for
cancer (LADG) is unclear in low to middle income countries as resources
are limited. Therefore, the aim of this study was to evaluate the safety and
feasibility of (LADG) in low to middle income countries; Egypt
as an example. Methods: Thirty four Patients with stage I-II cancer at the pylorus and antrum have
been enrolled for LADG between 2012 and 2015 with the reuse of single use vascular sealing
device has been evaluated. Results: Finally 27 patients had been included in the study
and successful LADG has been done for all selected cases. The average operative
time was 151 ± 10 minutes. The average estimated blood loss was 73.3 ± 13 ml.
No intra-operative complications have been recorded. The average time for post-operative
patient ambulation was 9 hours (SD ± 1.8) and for oral fluid intake was 3.5 SD
± 1 days. The average duration of the hospital stay was 9.3 ± 1.2 days. The
average number of retrieved lymph nodes was 21.7 ± 3.8 days. All the cases had
free surgical margin. The median number of reuse of the vascular sealing device
was 3.8 times (3 - 5 times). Conclusion: Laparoscopic
distal gastrectomy for cancer could be safe and feasible in developing
countries and give similar results for that of developed countries. Safe reuse
of single use expensive parts of some instruments for laparoscopy could help in
utilization of these advanced surgeries in low to middle income countries. Long
term follow up as well as comparative studies with open surgery are required.