Laparoscopy-assisted proximal gastrectomy with gastric tube reconstruction for early gastric cancer.

Aihara, Ryuusuke; Mochiki, Erito; Ohno, Teturo; Yanai, Mituhiro; Toyomasu, Yoshitaka; Ogata, Kyoichi; Ando, Hiroyuki; Asao, Takayuki; Kuwano, Hiroyuki

BACKGROUND In this report, laparoscopy-assisted proximal gastrectomy (LAPG) and gastric tube reconstruction using a mini-loop retractor (MLR) is described for the treatment of early gastric cancer. METHODS Early upper gastric carcinoma with no metastasis had been diagnosed in the subjects of this study. Five surgical ports were inserted into the abdomen. The stomach was lifted to the abdominal wall side with a MLR. Three of five gastric arteries were divided using ultrasonically activated coagulating shears and ligated with ligation forceps. A fixed gastric part with MLR was properly changed according to the lymph node dissection. Reconstruction with a gastric tube (20 cm long, 3 cm wide) using a circular stapler was performed through a small incision, through which the specimen was removed. RESULTS Fourteen patients underwent LAPG. The mean operating time and blood loss were 202 min and 236 ml, respectively. The operations were performed without serious complications. None was changed to a laparotomy, and there were no deaths. CONCLUSIONS This technique of LAPG and gastric tube reconstruction using MLR for the treatment of proximal early gastric cancer was simple and safe.