LAPAROSCOPIC SUBTOTAL GASTRECTOMY WITH LYMPHADENECTOMY IN A PATIENT WITH EARLY GASTRIC-CANCER

Laparoscopic surgery is rapidly gaining in popularity among general su rgeons. It is not widely used to treat abdominal malignancies because of technical difficulties and the fear of peritoneal dissemination. We describe the use of laparoscopic surgery to treat early gastric cance r. A 66-year-old man was diagnosed with early gastric adenocarcinoma b y endoscopic ultrasonography and biopsy. Subtotal gastrectomy along wi th removal of the perigastric (D1) and selective extra-perigastric lym ph nodes over the celiac trunk was accomplished laparoscopically, thro ugh five punctures and a minilaparotomy. The patient's convalescence w as uneventful. Bowel sounds were heard on postoperative day 1. On post operative day 3, he passed flatus. The patient was stal ted on a clear liquid diet on postoperative day 5. There was neither leakage nor obs truction after oral intake. He was discharged on postoperative day 11. No local recurrence or distant metastasis was found during 16 months' follow-up. This is the first report of successful laparoscopic resect ion of early gastric cancer with lymph node dissection in Taiwan.