A prospective randomized study comparing open vs laparoscopy-assisted distal gastrectomy in early gastric cancer

Background: We conducted a prospective randomized trial to compare laparoscopy-assisted distal gastrectomy (LADG) including lymphadenectomy with open distal gastrectomy for the management of early gastric cancer (EGC). Methods: Forty-seven patients who had been diagnosed endoscopically with EGC were included in a study that ran from November 2001 to August 2003. With the aid of random number table, 23 patients were assigned to the open group (group 0) and 24 patients were assigned to the LADG group (group L). Results: Estimated blood loss and transfusion amounts were similar in the two groups. The mean postoperative hospital stay and the duration of analgesic administration were shorter for group L but not significantly so. The mean number of harvested lymph nodes was 38.1 in the 0 group and 31.8 in the L group (p = 0.098). Postoperative pulmonary complications occurred more frequently in the 0 group (p = 0.043). At a median follow-up of 14 months, there has been no recurrence of disease in either group. Conclusion: In terms of resulting in fewer pulmonary complications while maintaining the curability of EGC, LADG has a clear advantage over its open counterpart.