Laparoscopy‐Assisted Distal Gastrectomy Versus Open Distal Gastrectomy. A Prospective Randomized Single‐Blind Study
- 20 June 2013
- journal article
- research article
- Published by Wiley in World Journal of Surgery
- Vol. 37 (10), 2379-2386
- https://doi.org/10.1007/s00268-013-2121-7
Abstract
Laparoscopy-assisted distal gastrectomy (LADG) is generally considered superior to open distal gastrectomy (ODG) with regard to postoperative quality-of-life. Differences in postoperative pain may exist due to recent pain control techniques including epidural anesthesia. There is little evidence for this difference. In this article we report the results of our randomized single-blind study in LADG versus ODG. The aim of the present study was to evaluate differences in postoperative physical activity between LADG and ODG. Forty patients with early gastric cancer (stage IA and IB) were registered in this randomized study. For strict evaluation, patients were not told about the type of operation until postoperative day 7. Postoperative physical activity was evaluated objectively by Active Tracer, which records the cumulative acceleration over a 24 h period to investigate differences in postoperative recovery. Questionnaire and visual analog scale score related to postoperative pain were also investigated. Significant differences were observed with a more favorable outcome noted in the LADG group with respect to intraoperative blood loss (P < 0.001), total amount of pain rescue (P < 0.001), wound size (P < 0.001), postoperative hospital stay (P < 0.001), and inflammatory parameters (C-reactive protein, SaO2, and duration of febrile period) (P < 0.001). Cumulative physical recovery to 70 % of the preoperative level was significantly shorter (by 3 days, P < 0.001) in the LADG group. Comparison of LADG and ODG for patients with early gastric cancer showed favorable outcome and earlier recovery of physical activity in the LADG group.Keywords
This publication has 19 references indexed in Scilit:
- Improved Quality of Life Outcomes After Laparoscopy-Assisted Distal Gastrectomy for Early Gastric CancerAnnals of Surgery, 2008
- Assessment of pain by face scales after gastrectomy: comparison of laparoscopically assisted gastrectomy and open gastrectomySurgical Endoscopy, 2008
- Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancerSurgical Endoscopy, 2005
- A Comparison of Laparoscopically Assisted and Open Colectomy for Colon CancerNew England Journal of Medicine, 2004
- Is laparoscopic colorectal surgery less invasive than classical open surgery? Quantitation of physical activity using an accelerometer to assess postoperative convalescenceSurgical Endoscopy, 2003
- Short-term Quality-of-Life Outcomes Following Laparoscopic-Assisted Colectomy vs Open Colectomy for Colon CancerA Randomized TrialJAMA, 2002
- A randomized controlled trial comparing open vs laparoscopy-assisted distal gastrectomy for the treatment of early gastric cancer: An interim reportSurgery, 2002
- The usefulness of laparoscopy-assisted distal gastrectomy in comparison with that of open distal gastrectomy for early gastric cancerGastric Cancer, 2001
- Quantitating Physical Activity in COPD Using a Triaxial AccelerometerChest, 2000
- A randomized, prospective, blinded comparison of postoperative pain, metabolic response, and perceived health after laparoscopic and small incision cholecystectomySurgery, 1998