The Applicability and Outcome of Laparoscopic Gastric Resection
Abstracts
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The application of laparoscopy in the treatment of gastric disease is becoming increasingly more frequent. We present our series of laparoscopic gastric resections to evaluate the efficacy of this approach. Thirty-four patients, 15 male and 19 female, underwent 35 laparoscopic gastric resections at three tertiary care institutions from 1997 to 2001. The patients ranged in age from 24 to 83 years, mean 55. Twenty-six patients had multiple comorbidities. Twelve patients had previous abdominal surgeries. The mean ASA score was 2.3, range 1 to 3. The mean Body Mass Index (BMI) was 29.9 kg/m2, range 20 to 51 kg/m2. There were 15 patients with BMI > 30 kg/m2. There were 9 enucleations, 12 wedge resections, 10 partial gastric resections, and 3 total gastrectomies. The majority of patients were treated for gastric stromal tumors. The remaining pathology included three adenocarcinomas, one lymphoma, one gastrinoma, and eight other benign lesions. The mean operative time was 180.7 minutes, range 65 to 447 minutes. Four patients underwent seven concomitant operations. There were four hand-assisted operations and no conversions. The mean estimated blood loss was 98 cc (10 to 450 cc). There were two complications of post-operative bleeding that required transfusion. There were 5 minor complications. There were no procedure-related deaths. The patients returned to oral intake in 1 to 5 days (mean 2.8 days). The average length of stay was 4.0 days (range 2 to 7 days). Laparoscopic gastric resection is an effective approach in the treatment of gastric pathology of varying etiologies. This technique can be applied safely to patients, including those with previous operations, high BMIs, and significant comorbidities, resulting in early return to oral intake and short hospital stays. |
