Eleven-year experience with 3000 cases of laparoscopic XXXX surgery in a single institution: analysis of postoperative morbidities and long-term oncologic outcomes.

@entity1 @entity5 @entity356 @entity548
BACKGROUND: The present study summarizes the 11-year laparoscopic @entity356 surgery experience of a single institution in South Korea and evaluates the current trends of laparoscopic @entity356 surgery through our experience. METHODS: A total of 3000 minimally invasive @entity356 surgeries were performed at Seoul National University Bundang Hospital between May 2003 and January 2014. The types of laparoscopic gastrectomy used, surgical techniques, postoperative morbidities, and long-term oncologic outcomes were analyzed. RESULTS: The proportion of challenging procedures such as laparoscopic total gastrectomy and laparoscopic gastrectomy for @entity1 with advanced @entity356 increased during the study period. The frequency of laparoscopic function-preserving gastrectomy for @entity1 with early-stage @entity5 also increased. The overall rate of complications was 16.7  %; surgical and systemic complication rates were 11.8 and 6.2  %, respectively. There was one case of postoperative mortality due to delayed @entity548 after discharge. Male gender, high BMI, long operating times, combined resection of other organs, and total and proximal gastrectomies were independent predictors of surgical morbidities; however, pathologic T-stage was not a predictable factor. Accumulated experience in laparoscopic surgery decreased the surgical complication rates of total and proximal gastrectomies more than it did in distal gastrectomy over time. The 5-year overall survival rates of @entity1 in advanced stages and those who underwent laparoscopic total gastrectomy were comparable to those reported previously. CONCLUSIONS: Our results indicate the trends toward the expansion of laparoscopic approaches to technically demanding procedures and an increased use of laparoscopic function-preserving surgeries for @entity1 with EGC with acceptable outcomes.
