Clinical Outcomes of Totally Laparoscopic Total Gastrectomy versus Open Total Gastrectomy for Remnant Gastric Cancer

Abstract

This study compares the feasibility and safety of Totally Laparoscopic Total Gastrectomy (TLTG) with Open Total Gastrectomy (OTG) for Remnant Gastric Cancer (RGC) in patients who had previously undergone gastrectomy. Methods: We retrospectively collected and analyzed the data of 139 consecutive patients who underwent OTG along with 21 patients who underwent TLTG for RGC between January 2008 and December 2016. One-to-two Propensity Score Matching (PSM) was performed to compare the age, gender, body mass index, American Society of Anesthesiologists score, clinical tumor stage, previous gastric disease, previous gastrectomy type, previous reconstruction type, history of previous upper abdominal surgery except gastrectomy, and combined major operations. A total of sixty patients (21 who underwent TLTG and 39 who underwent OTG) were matched, and surgical outcomes and survival rates were compared. Results: The TLTG patients were found to recover bowel movements sooner than the OTG group (OTG 3.74±0.88 vs TLTG 3.19±0.81 days, p=0.02). Post-operative surgical outcomes, including pathological features, clinical courses, complications and survival rates did not differ between the two groups (p>0.05). Conclusion: Although TLTG was not found to have any definitive clinical advantage over OTG except for more rapid recovery of bowel movement, TLTG should be considered as safe and feasible surgical procedure as OTG for the treatment of RGC.

Is Totally Laparoscopic Total Gastrectomy Better Than Laparoscopy- Assisted Total Gastrectomy For Clinical Stage I Gastric Cancer? A Propensity-Score Matched Analysis

“…The unpredictability of abdominal pain caused by adhesions signi cantly impacts on a patient's emotions and social life, including fear for eating [41]. We assume that less exposure of the peritoneal cavity, especially the upper abdomen, may induce less adhesion around the anastomosis or provide better recovery of bowel movement [42][43][44]. Taken together, not only the possible different exposure of peritoneal cavity but also the different anastomotic technique may explain the different QoL in this study.…”

The safety, feasibility, and oncological outcomes of laparoscopic completion total gastrectomy for remnant gastric cancer: a prospective study with 3-year follow-up (FUGES-004 study)

“…Regarding long-term oncological efficacy, several retrospective studies have reported comparable OS rates between the LCTG and OCTG groups 4 , 18 , 21 , 22 , 25 , 26 . However, these studies were limited by sample sizes and short follow-up durations (less than 3-year), making the results less reliable and robust for further clinical application.…”

Postoperative morbidity and quality of life between totally laparoscopic total gastrectomy and laparoscopy-assisted total gastrectomy: a propensity-score matched analysis

“…The unpredictability of abdominal pain caused by adhesions significantly impacts on a patient’s emotions and social life, including fear for eating [ 46 ]. We assume that less exposure of the peritoneal cavity, especially the upper abdomen, may induce less adhesion around the anastomosis or provide better recovery of bowel movement [ 47 – 49 ]. Taken together, not only the possible different exposure of peritoneal cavity but also the different anastomotic technique may explain the different QoL in this study.…”