Clinical Pathway for Treating Early Gastric Cancer by Laparoscopy-Assisted Gastrectomy

A clinical pathway for treating early gastric cancer by laparoscopy-assisted gastrectomy (LAG) was introduced in our department in July 2001. We reviewed the records of 40 patients who have undergone LAG at our department to evaluate the effects of introduction of this clinical pathway. We compared the data of the 17 patients out of those 40 patients who underwent LAG after the introduction of the clinical pathway with those of the 23 patients who underwent LAG before its introduction, in terms of the sex, age, operative technique, lymph node dissection, operating time, blood loss, postoperative complications, post operative course and total cost during the hospital stay and the average daily cost of hospitalization. The postoperative course was evaluated in terms of the interval until standing, walking, removal of the NG tube, urinary catheter and drainage tube, oral intake, and postoperative hospital stay. There were no significant differences in any of these parameters between the two groups, except for lymphnode dissection. Negative variances of post operative stay were observed in 6 patients, including two patients who suffered from postoperative complications, two whose family desired a longer stay and two whose stay were prolonged due to our system. Assessment and correction of these variances may be expected to allow us to provide better medical service