BACKGROUND: Pylorus-preserving gastrectomy (PPG) prevents postprandial symptoms; however, delayed gastric retention due to aberrant pylorus function can occur during the early postoperative period. This study aimed to establish a stasis-less PPG procedure with preservation of the vagal nerve and blood flow to the pyloric cuff, and to apply the technique for laparoscopy-assisted PPG. METHODS: Ninety patients with T1 gastric cancer located in the middle third of the stomach were enrolled in this study for surgery from January 2003 to March 2006, undergoing either laparoscopy-assisted PPG (LAPPG; 39 patients) or conventional PPG (CPPG; 51 patients). Operative and early postoperative outcomes were compared between the two groups. RESULTS: Relatively low rates of gastric stasis were observed in both the LAPPG (8%) and CPPG (6%) groups. Estimated blood loss in LAPPG (65.4 +/- 12.3 ml) patients was significantly lower than in the CPPG group (160.7 +/- 19.6 ml) (p < 0.001), and the total number of dissected lymph nodes was significantly greater in the LAPPG group (36.2 +/- 1.8) than in the CPPG group (29.0 +/- 1.3) (p = 0.001). CONCLUSIONS: A PPG procedure with less postoperative stasis and adequate lymph node retrieval was established and applied successfully in laparoscopy-assisted surgery.
BACKGROUND: Pylorus-preserving gastrectomy (PPG) prevents postprandial symptoms; however, delayed gastric retention due to aberrant pylorus function can occur during the early postoperative period. This study aimed to establish a stasis-less PPG procedure with preservation of the vagal nerve and blood flow to the pyloric cuff, and to apply the technique for laparoscopy-assisted PPG. METHODS: Ninety patients with T1 gastric cancer located in the middle third of the stomach were enrolled in this study for surgery from January 2003 to March 2006, undergoing either laparoscopy-assisted PPG (LAPPG; 39 patients) or conventional PPG (CPPG; 51 patients). Operative and early postoperative outcomes were compared between the two groups. RESULTS: Relatively low rates of gastric stasis were observed in both the LAPPG (8%) and CPPG (6%) groups. Estimated blood loss in LAPPG (65.4 +/- 12.3 ml) patients was significantly lower than in the CPPG group (160.7 +/- 19.6 ml) (p < 0.001), and the total number of dissected lymph nodes was significantly greater in the LAPPG group (36.2 +/- 1.8) than in the CPPG group (29.0 +/- 1.3) (p = 0.001). CONCLUSIONS: A PPG procedure with less postoperative stasis and adequate lymph node retrieval was established and applied successfully in laparoscopy-assisted surgery.