Comparison of perioperative outcomes between bipolar sealing, ultrasonic shears and a hybrid device during laparoscopic gastrectomy for early gastric cancer: a prospective, multicenter, randomized study

Park, Ji‐Hyeon; Kong, Seong‐Ho; Berlth, Felix; Choi, Jong‐Ho; Kim, Sara; Kim, Sa-Hong; Lee, Sangjun; Yoo, Jaeun; Goo, EunHee; Jeong, Kyoungyun; Kim, Hyun Myong; Park, Young Suk; Ahn, Sang-Hoon; Suh, Yun-Suhk; Park, Do Joong; Lee, Hyuk-Joon; Kim, Hyung‐Ho; Yang, Han–Kwang

doi:10.1007/s10120-023-01365-6

Cited by 2 publications

(3 citation statements)

References 40 publications

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“…Recently, a randomized controlled study comparing the short‐term surgical results of laparoscopic gastrectomy for GC between the groups using US and those using bipolar devices was published in Korea. 29 The results showed that postoperative CRP levels were significantly higher in the US group than in the bipolar group. The authors speculated that the higher CRP levels in the US group might be associated with pancreatic thermal damage.…”

Section: Discussionmentioning

confidence: 91%

“…They speculated that thermal damage to the pancreatic parenchyma was likely to be less in the bipolar device than in the US. Recently, a randomized controlled study comparing the short‐term surgical results of laparoscopic gastrectomy for GC between the groups using US and those using bipolar devices was published in Korea 29 . The results showed that postoperative CRP levels were significantly higher in the US group than in the bipolar group.…”

Section: Discussionmentioning

confidence: 99%

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Impact of a robotic system on intra‐abdominal infectious complications after minimally invasive gastrectomy in patients with gastric cancer: A propensity score matching analysis regarding visceral obesity

Kubo,

Sakurai,

Hasegawa

et al. 2023

Annals of Gastroent Surgery

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BackgroundThe efficacy of robotic gastrectomy (RG) on postoperative complications in patients with gastric cancer (GC) is unclear in terms of the volume of intra‐abdominal fat tissue.Patients and MethodsWe enrolled 403 patients with GC who had minimally invasive surgery between January 2015 and July 2022. During this time, 197 RG and 206 laparoscopic gastrectomies (LG) were performed on the study participants. According to the computed tomography scan, patients were defined as having or not having visceral obesity based on the visceral fatty area (VFA). In each high and low VFA group, we compared short‐term outcomes between the RG group and LG group.ResultsAfter PS matching for patients with high VFA, the two groups were well matched, with 71 cases in both the RG and LG groups. The median surgical time in the RG group was significantly longer (420 vs. 365 min, p < 0.001). However, the RG group had a significantly lower rate of severe intra‐abdominal infectious complications (IAIC), such as anastomotic leakage, pancreatic fistula, and intra‐abdominal abscess (1.4% vs. 15.4%, p = 0.004). However, among the 77 patients with low VFA values, we found no significant difference in the rate of severe IAIC between the two groups (1.1% in the RG group vs. 2.6% in the LG group, p = 1.00).ConclusionRG may be a viable alternative to LG because of the lower postoperative IAIC for patients with visceral obesity and GC. However, RG may not benefit non‐obese patients.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Impact of a robotic system on intra‐abdominal infectious complications after minimally invasive gastrectomy in patients with gastric cancer: A propensity score matching analysis regarding visceral obesity

Kubo,

Sakurai,

Hasegawa

et al. 2023

Annals of Gastroent Surgery

View full text Add to dashboard Cite

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“…In recent years, with the wide application of anastomotic instruments, the attention of perioperative management, and the progress of operation and anesthesia, the incidence of postoperative complications of gastric cancer has decreased signi cantly [21,22].The need for routine placement of abdominal drainage tube after gastric cancer operation for early detection of anastomotic leakage and intra-abdominal bleeding is no longer urgent.According to the results of the relevant prospective randomized controlled study, the intraoperative placement of abdominal drainage tube group did not signi cantly reduce the incidence of postoperative complications such as anastomotic leakage and intraabdominal bleeding [1,13].Therefore, they do not recommend the prophylactic placement of abdominal drainage tube during the operation of gastric cancer.Although the absence of abdominal drainage tube after radical resection of gastric cancer makes clinicians lack an intuitive indicator of postoperative bleeding or anastomotic leakage.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Abdominal Drainage After Gastrectomy: An Updated Meta-Analysis

Zhu

Zhou

Sun

et al. 2023

Preprint

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Introduction: At present, there is no convincing evidence-based medical basis for the placement of prophylactic drain after gastrectomy.This meta-analysis aimed to analyze the incidence of complications and the recovery of gastrointestinal function after gastrectomy in the drain group and the no-drain group. Methods: Data were retrieved from electronic databases PubMed, EMBASE, Medline, Cochrane Library, CNKI, Wanfang and VIP databases up to December 2022, including the outcomes of individual treatment after gastrectomy. Complication related index:Incidence of Postoperative Complications, Anastomotic leak，Intra-abdominal bleeding, Wound Infection, Hospital mortality, Pulmonary infection, Intra-abdominal abscess, Abdominal infection, Readmission, Reoperation, Drain related complications etc. Recovery of gastrointestinal function related index: Passage of flatus, Initiation of soft diet, Hospital stay after surgery. The Jadad score and Newcastle-Ottawa scale were used to assess the quality of the included studies. Results: After screening, 20 literatures were finally included, including 4984 patients. Meta-analysis results showed that the passage of flatus（WMD=0.32, 95%CI=0.07~0.58, P=0.01）and initiation of soft diet（WMD=0.45, 95%CI=0.20~0.71, P=0.0005）in the no-drain group were better than those in the drain group. The drain group was not superior to the no-drain group in hospital stay after surgery, postoperative complications, wound infection, pulmonary infection, anastomotic leakage, intra-abdominal abscess, intra-abdominal bleeding, intra-abdominal infection, mortality, reoperation, readmission, and drainage-related complications. Conclusions: Prophylactic placement of the peritoneal drainage tube did not reduce the incidence of early complications but delayed recovery of gastrointestinal function. Abdominal drainage is not required after radical gastrectomy, but is recommended for high-risk patients with anastomotic fistula and intraperitoneal bleeding.

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Comparison of perioperative outcomes between bipolar sealing, ultrasonic shears and a hybrid device during laparoscopic gastrectomy for early gastric cancer: a prospective, multicenter, randomized study

Cited by 2 publications

References 40 publications

Impact of a robotic system on intra‐abdominal infectious complications after minimally invasive gastrectomy in patients with gastric cancer: A propensity score matching analysis regarding visceral obesity

Impact of a robotic system on intra‐abdominal infectious complications after minimally invasive gastrectomy in patients with gastric cancer: A propensity score matching analysis regarding visceral obesity

Prophylactic Abdominal Drainage After Gastrectomy: An Updated Meta-Analysis

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