| [ Summary ] |
Since 1991, sixty three patients with early-stage gastric cancer have been successfully treated using three different laparoscopic techniques. As the operation without lymph nodes dissection, laparoscopic wedge resection using lesion lifting method (LWR,n=13) and intragastric mucosal resection (IGMR, n=3) have performed according to the localization of the lesion. In the remaining 47 patients, we have designed and performed laparoscopy-assisted distal(LADG) or proximal (LAPG) gastrectomy with regional lymph nodes (D1+alpha) dissection. The indications for laparoscopy-assisted gastrectomy (LAG) are as follows; 1) mucosal cancer>10mm in diameter or with ulcerated scars,when the lesion is depression type, 2) mucosal cancer>20mm in diameter, when lesion is protruded type, 3) submucosal cancer with slightly invasion. There was no complication except one case with pneumia after LAG. That patient had suffered from chronic bronchitis for the past 10 years. All patients who underwent LWR and IGMR were discharged within 5-8 days without a complication, and all patients performed LAG within 11-15 days. Histological examinations of resected specimens revealed that all surgeries were successful. In conclusion, laparoscopic surgery for early-stage gastric cancers is seen to be useful from the viewpoints of curability and minimal invasiveness. |