Disadvantage of Operation Cost in Laparoscopy-Assisted Distal Gastrectomy under the National Health Insurance System in Japan

Background: The utility and problems including the socioeconomic aspect of laparoscopy-assisted distal gastrectomy for gastric cancer have not been fully evaluated. Subjects and Methods: We compared open distal gastrectomy and laparoscopy-assisted distal gastrectomy for the clinical benefit, quality of life, and problems of operation cost by the reference documents in which the difference between open distal gastrectomy and laparoscopy-assisted distal gastrectomy was examined in detail. The reference documents retrieved by the key words ‘gastric, cancer, laparoscopic, surgery’ were 22 in PubMed with the following limits activat ed: Humans, Clinical Trial, Meta-Analysis, Randomized Controlled Trial, Review, English, Core clinical journals, published in the last 10 years. Results: The operation time of laparoscopy-assisted distal gastrectomy is longer than that of open distal gastrectomy. However, if skilled, the blood loss of laparoscopy-assisted distal gastrectomy is less, the hospitalization days and the duration of fasting after laparoscopy-assisted distal gastrectomy are shorter than those after open Published online: September 14, 2010 Yoshiyuki Hoya Department of Surgery, Daisan Hospital, Jikei University School of Medicine 4-11-1, Izumihon-cho, Komae-shi Tokyo 201-8601 (Japan) Tel. +81 3 348