Comparative study of laparoscopic<i>vs</i>open gastrectomy in gastric cancer management

Sica, Giuseppe

doi:10.3748/wjg.v17.i41.4662

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…As regards lymphadenctomy, the mean number of retrieved lymph nodes reported by Asian authors after laparoscopic D2 dissection ranges from 23 to 49, 18 whereas it ranges from 15 to 35 in Western observational studies. 5,[7][8][9][29][30][31] Our outcomes, with a mean number of 30.0 examined lymph nodes, are comparable with these previously reported results and, importantly, are in line with Western criteria (number of lymph nodes harvested > 25) regarding adequate D2 dissection and thus surgical quality for advanced gastric cancer. 38 In conclusion, within the limitations of a nonrandomized analysis, our study contributes to the Western experience by demonstrating both the safety and oncologic efficacy of the laparoscopic approach to the resection of gastric adenocarcinoma.…”

Section: Cianchi Et Alsupporting

confidence: 90%

“…and only a few studies comparing laparoscopic and open gastrectomies are prospective or randomized. [5][6][7][8] However, all these studies have clearly shown that the laparoscopic approach can actually reduce surgical trauma and improve the patient's quality of life during the postoperative period compared with the open procedure. 9 Some skepticism still remains regarding the oncological efficacy of the laparoscopic treatment of gastric cancer, in particular on the extent of lymphadenectomy.…”

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confidence: 99%

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Totally Laparoscopic Versus Open Gastrectomy for Gastric Cancer: A Matched Cohort Study

Cianchi

Qirici²,

Trallori³

et al. 2013

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: The role of laparoscopic surgery for the treatment of gastric cancer is still controversial, particularly in terms of oncologic efficacy. The aim of this study was to compare short-term outcomes of laparoscopic and open resection for gastric cancer at a single Western institution. Subjects and Methods: This study was designed as a matched cohort study from a prospective gastric cancer database. Forty-one patients undergoing laparoscopic gastrectomy for gastric cancer between June 2008 and January 2012 were matched with 41 patients undergoing open gastrectomy in the same time period. Patient pairing was done according to age, gender, type of gastrectomy (subtotal or total), and tumor stage via a randomized statistical method. The short-term outcomes and oncologic adequacy of the laparoscopic and open procedures were compared. A D2 lymph node dissection was performed in the majority of patients in both groups. Results: The two study groups were similar with respect to patient and tumor characteristics. Laparoscopic procedures were associated with a decreased blood loss (118.7 versus 312.4 mL, P < .005), incidence of surgeryunrelated complications (3 versus 9 patients, P < .05), and duration of hospital stay (8.1 versus 11.5 days, P < .05) but increased operative time for both subtotal (223.5 versus 158.2 minutes, P < .001) and total (298.1 versus 185.5 minutes, P < .001) gastrectomies. The mean number of retrieved lymph nodes after D2 dissection was similar: 30.0 for laparoscopic and 29.7 for open patients. Conclusions: Within the limitations of a nonrandomized analysis, this study shows that the laparoscopic approach is a safe and oncologically adequate option for the treatment of gastric cancer, which compares favorably with open gastrectomy in short-term outcomes.

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Section: Cianchi Et Alsupporting

confidence: 90%

mentioning

confidence: 99%

Totally Laparoscopic Versus Open Gastrectomy for Gastric Cancer: A Matched Cohort Study

Cianchi

Qirici²,

Trallori³

et al. 2013

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…Another important factor was a significantly higher harvest of lymph nodes for patients undergoing open distal gastrectomy. Further retrospective studies from Asia as well as one prospective trial from Italy confirmed the major aspects of these data [26][27][28]. The rate of recurrence or metachronous metastases was similar for both procedures.…”

Section: Treatment Of Gastric Cancersupporting

confidence: 52%

Helicobacter pylori: Gastric Cancer and Extragastric Intestinal Malignancies

et al. 2012

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The greatest challenge in Helicobacter pylori-related diseases continues to remain prevention of gastric cancer. New evidence supports the beneficial effect of H. pylori eradication not only on prevention of gastric cancer but also on the regression of preneoplastic conditions of the gastric mucosa. Concerning early detection of gastric cancer there are still no adequate means and there is urgent need to define appropriate markers, for example, by gen-ome-wide research approaches. Currently, the best available method is the "serologic" biopsy based on pepsinogen I and the pepsinogen I/II ratio for identification of patients with severe gastric atrophy at increased risk for gastric cancer development. The treatment of early gastric cancer by endoscopic techniques can be performed safely and efficiently, but patients need meticulous follow-up for detection of metachronous lesions. In case of advanced disease, laparoscopically assisted surgical procedures are safe and favorable compared to open surgery. Two phase III trials support the role of adjuvant systemic treatment with different regimens. Unfortunately, there is still only slow progress in the development of palliative treatment regimens or modification of the existing therapy protocols. There is accumulating evidence for a role of H. pylori infection also in colorectal carcinogenesis. Seropositive individuals are at higher risk for the development of colorectal adenomas and consequently adenocarcinomas of this anatomical region. This phenomenon can partly be attributed to the increase of serum gastrin as response to atrophic changes of the gastric mucosa. In 2012, the infection with Helicobacter pylori remains one of the most challenging infectious diseases of the world, causing high morbidity and mortality. The major burden in global health care is still given by H. pylori representing the main risk factor for gastric cancer (GC), the second leading cause of cancer-related death. During the past years, the progress in the clinical management of GC has been modest. Innovations are limited to modifications of the existing chemotherapy regimens in either palliative or perioperative settings. Furthermore, new data have been gained concerning the endoscopic treatment of early GC. This review summarizes recent clinical-and research-related advances in the field of H. pylori and GC that have been published between April 2011 and April 2012, including also recent insights concerning the association between H. pylori infection and colorectal neoplasias. Prevention and Screening of Gastric Cancer H. pylori infection leads in all infected individuals to a chronic active gastritis, which can proceed, via the so-called Correa cascade, to gastric mucosal atrophy and intestinal metaplasia (IM), and finally to the development of GC. Thus, atrophy and IM are considered as precancerous conditions, and H. pylori eradication therapy is considered as preventive for GC [1]. Several studies have proven that eradication therapy also improves, or at least prevents, progression of ...

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“…A small-scale RCT and several retrospective studies have demonstrated no significant differences in survival rate, recurrence rate and type of recurrence between LAG and COG (12,(24)(25)(26). Furthermore, a retrospective study by multivariate analysis found that depth of invasion and progression of lymph node metastasis were determinants of prognosis, indicating that survival was not an issue of approach, i.e.…”

Section: Evidence Regarding Long-term Survival Outcomesmentioning

confidence: 99%

Minimally invasive surgery for stomach cancer

Nunobe

Kumagai

Ida

et al. 2016

Jpn. J. Clin. Oncol.

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Laparoscopic surgery for gastric cancer has become extremely widespread in recent years especially in Asian countries due to its low invasiveness. As to evidence of indication for laparoscopic surgery for gastric cancer, laparoscopic surgery for gastric cancer often appears to be indicated for early gastric cancer at many institutions, while evidence was considered to be insufficient to recommend laparoscopic surgery for gastric cancer at Stage II and above. There are also problems with indications for cases other than tumour factors. No meta-analyses and prospective studies have been reported, but outcomes of laparoscopic surgery for gastric cancer in gastric cancer patients with co-morbid and/or existing diseases have been reported in retrospective studies. Indications in the elderly appear to be favourable in terms of post-operative ambulation considering factors such as the degree of dissection in accordance with the status of the patient. Meta-analyses, randomized controlled trials and several retrospective studies have compared the short-term usefulness of laparoscopic surgery for gastric cancer with that of conventional gastrectomy. The superiority of laparoscopic surgery for gastric cancer has been reported in terms of the reduced amount of bleeding, a reduction in the administration frequency and period of analgesic doses, a reduction in the duration of fever, early recovery of intestinal movement and early return to oral intake. A small-scale randomized controlled trial and several retrospective studies have demonstrated no significant differences in survival rate, recurrence rate and type of recurrence between laparoscopic surgery for gastric cancer and conventional gastrectomy. The results of the aforementioned trials in early gastric cancer in Japan and Korea for which enrolment is complete remain to be published.

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Comparative study of laparoscopicvsopen gastrectomy in gastric cancer management

Cited by 3 publications

References 15 publications

Totally Laparoscopic Versus Open Gastrectomy for Gastric Cancer: A Matched Cohort Study

Totally Laparoscopic Versus Open Gastrectomy for Gastric Cancer: A Matched Cohort Study

Helicobacter pylori: Gastric Cancer and Extragastric Intestinal Malignancies

Minimally invasive surgery for stomach cancer

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