Comparison of the cost and outcomes following totally laparoscopic and laparoscopy-assisted distal gastrectomies for XXXX : a single-institution comparison.

@entity1 @entity834 @entity5 @entity190 @entity254 @entity850 @entity356
OBJECTIVE: This study aimed to compare the short-term surgical outcomes and cost-benefits following totally laparoscopic distal gastrectomy (TLDG) and laparoscopy-assisted distal gastrectomy (LADG) for the treatment of @entity356 . METHODS: Between April 2007 and December 2013, a total of 100 @entity1 with @entity356 underwent laparoscopic distal gastrectomy. The @entity1 were classified into two groups according to whether intracorporeal @entity254 or extracorporeal @entity254 had been performed. The comparison between the groups was based on clinicopathological characteristics and surgical and economic outcomes. RESULTS: There were 57 and 43 @entity1 who underwent TLDG and LADG, respectively. The @entity1 ' demographics and @entity5 characteristics did not show any statistically significant differences with the exception for @entity5 location. In the LADG group, @entity5 were localized to relatively higher positions (p  =  0.024) and received Roux-en-Y reconstruction more frequently (p  <  0.001). There were no differences in the incidence of morbidity. @entity834 was not recorded in either group, although @entity850 occurred in one @entity1 (1.8  %) after TLDG and in two @entity1 (4.7  %) after LADG. Compared with the LADG group, the TLDG group was associated with significantly less operative @entity190 (p  <  0.001), a shorter time to oral intake (p  =  0.012), and hospital stay (p  =  0.018). The median operation costs were greater in the TLDG group than in the LADG group (  982,000 in TLDG vs.   879,830 in LADG; p  <  0.001), whereas the median total hospital costs were similar between the two groups (  1302,665 in LADG vs.   1383,322 in TLDG: p  =  0.119). CONCLUSION: This study suggests that TLDG is as technically feasible, safe, and effective as LADG for treating @entity1 with @entity356 . Furthermore, TLDG is associated with equivalent total hospital costs compared with LADG. The increased operation cost is offset by the decreased costs associated with longer periods of hospitalization.
