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Original Article
Laparoscopy-assisted Distal Gastrectomy with Systemic D2 Lymphadenectomy for Gastric Cancer: Usefulness of Noncompliance Rate to Validate the Completion of D2
Kyung Won Seo1, Kae Won Park2, Ki Young Yoon1
Kosin Medical Journal 2013;28(1):27-33.
Published online: January 19, 2013

1Department of Surgery, College of Medicine, Kosin University, Busan, Korea

2Postgraduate school, College of Medicine, Kosin University, Busan, Korea

Corresponding author: Ki Young YOON, Department of Surgery, College of Medicine, Kosin University, 262 Gamcheon-ro, Seo-gu, Busan, 602-703, Republic of Korea TEL: +82-51-990-6462 FAX: +82-51-246-6093 E-mail:
• Received: August 14, 2012   • Accepted: January 28, 2013

Copyright © 2013 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Objectives
    Laparoscopy-assisted distal gastrectomy (LADG) is a common surgical procedure that has recently been accepted as safe and feasible for the treatment of early gastric cancer. There have been many efforts to expand the indications of LADG to include the treatment of advanced gastric cancer. The aim of this study was to determine the usefulness of noncompliance rate as an indicator for D2 lymph node dissection (LND) validation in LADG.
  • Methods
    The subjects were 48 patients who underwent distal gastrectomy with D2 LND at Kosin University Gospel Hospital from October to December 2010. Of them, 28 underwent LADG and 20 underwent open distal gastrectomy (ODG). We compared several factors including noncompliance rate to validate D2 LND.
  • Results
    There were no significant differences in clinicopathologic factors except for BMI and tumor depth between the two groups. The average number of retrieved lymph nodes was significantly greater in the ODG group (45.9 ± 2.9) than in the LADG group (35.5 ± 2.0). The noncompliance rate was 43% in the LADG group and 40% in the ODG group with no significant difference.
  • Conclusions
    In terms of no difference of noncompliance rate, LADG with D2 lymph node dissection is a safe, feasible and oncologicallycamparable with open gastrectomy. A large scaled prospective randomized trial should be needed to confirm the benefit of LADG.
Table 1.
Patient clinicopathologic characteristics
Variables LADG (n = 28) ODG (n = 20) P
Sex M 21 15 1.000
F 7 5
BMI 23.7 ± 0.49 22.0 ± 0.45 0.019
T stage T1 26 8 0.001
T2 1 2
T3 1 5
T4 0 5
N stage N0 27 12 0.015
N1 1 4
N2 0 2
N3 0 2
Anastomosis Billroth I 23 16 0.856
Billroth II 5 4

Mean ± SEM.

Table 2.
Patient surgical outcomes
Variables LADG (n = 28) ODG (n = 20) P
Estimated blood loss 117.8 ± 18.2 230.0 ± 27.2 0.002
Op. time (min.) 199.6 ± 11.4 190.7 ± 7.7 0.521
Retrieved LN 35.5 ± 2.0 45.9 ± 2.9 0.006
Noncompliance rate 0.43 0.4 0.847
Hospital stay (days) 7.2 8.4 0.678
First flatus (days) 2.7 3.3 0.785
Starting semi-liquid diet 3 3 1
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        Laparoscopy-assisted Distal Gastrectomy with Systemic D2 Lymphadenectomy for Gastric Cancer: Usefulness of Noncompliance Rate to Validate the Completion of D2
        Kosin Med J. 2013;28(1):27-33.   Published online January 19, 2013
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