Comparison of short-term outcomes and acute inflammatory response between laparoscopy-assisted and totally laparoscopic distal gastrectomy for early gastric cancer

Lee, Sang Ho; Kim, In Ho; Kwak, Sang Gyu; Chae, Hyun Dong

doi:10.4174/astr.2015.89.4.176

Cited by 22 publications

(21 citation statements)

References 25 publications

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“…Time to first flatus was 1.5 days. Median LOS was 5 days, and it was generally shorter than the results presented by other authors [34–37]. In our opinion it is an effect of laparoscopy in combination with the ERAS protocol.…”

Section: Discussionsupporting

confidence: 40%

Laparoscopic Gastrectomy with Enhanced Recovery After Surgery Protocol: Single-Center Experience

et al. 2017

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BackgroundSurgery remains the mainstay of gastric cancer treatment. It is, however, associated with a relatively high risk of perioperative complications. The use of laparoscopy and the Enhanced Recovery After Surgery (ERAS) protocol allows clinicians to limit surgically induced trauma, thus improving recovery and reducing the number of complications. The aim of the study is to present clinical outcomes of patients with gastric cancer undergoing laparoscopic gastrectomy combined with the ERAS protocol.Material/MethodsFifty-three (21 female/32 male) patients who underwent elective laparoscopic total gastrectomy due to cancer were prospectively analyzed. Demographic and surgical parameters were assessed, as well as the compliance with ERAS protocol elements, length of hospital stay, number of complications, and readmissions.ResultsMean operative time was 296.4±98.9 min, and mean blood loss was 293.3±213.8 mL. In 3 (5.7%) cases, conversion was required. Median length of hospital stay was 5 days. Compliance with ERAS protocol was 79.6±14.5%. Thirty (56.6%) patients tolerated an early oral diet well within 24 h postoperatively; in 48 (90.6%) patients, mobilization in the first 24 hours was successful. In 17 (32.1%) patients, postoperative complications occurred, with 7 of them (13.2%) being serious (Clavien-Dindo 3-5). The 30-day readmission rate was 9.4%.ConclusionsThe combination of laparoscopy and the ERAS protocol in patients with gastric cancer is feasible and allows achieving good clinical outcomes.

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Section: Discussionsupporting

confidence: 40%

Laparoscopic Gastrectomy with Enhanced Recovery After Surgery Protocol: Single-Center Experience

et al. 2017

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“…Various therapeutic options are currently available for EGC, including endoscopic treatment, LG, and conventional open gastrectomy (3). LG has many advantages for patients with EGC, including good cosmesis, minimal postoperative pain, low operative stress, early postoperative recovery, early meal ingestion, a short postoperative hospital stay, and improved quality of life (17)(18)(19). The results of the present study indicate that LG for EGC is safe and feasible for elderly patients (9,20).…”

Section: Discussionmentioning

confidence: 69%

Safety and feasibility of laparoscopic gastrectomy accompanied by D1+ lymph node dissection for early gastric cancer in elderly patients

Yasukawa

Kadokawa

Kato

et al. 2018

Asian J Endoscop Surgery

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“…Moreover, we identified that a postoperative change in the fibrinogen concentration > 20% was useful for predicting postoperative major complications following gynecologic laparoscopic surgeries. The role of acute-phase proteins in predicting the development of postoperative complications have been already investigated, but, to date, the majority of studies have focused on CRP [23][24][25][26][27][28][29][30][31][32].…”

Section: Discussionmentioning

confidence: 99%

The utility of fibrinogen level as a predictor of complications after laparoscopic gynecologic surgery: a prospective observational study

et al. 2019

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Background: Complications after laparoscopic gynecological surgery may increase patients' morbidity and mortality; therefore, their timely diagnosis and early treatment would help clinicians to avoid life-threatening situations. We aimed to evaluate the predictive role of fibrinogen for diagnosing complications after laparoscopic gynecologic surgery for benign and malignant conditions. Patients and methods: All patients who underwent elective laparoscopic gynecologic surgery between June 2013 and December 2017 at the Department of Gynecologic Oncology, Azienda Ospedaliera Brotzu, Cagliari, were prospectively included. Post-operative complications were assessed and graded according to the Clavien-Dindo classification. Fibrinogen and white blood cell level were determined preoperatively, on the first post-operative day and at the appearance of symptoms indicative of an irregular post-operative course or at the time of rehospitalization for persistent symptoms. The postoperative changes (calculated from the first postoperative day) were correlated with the occurrence and severity of complications and their predictive role was assessed. Results: We enrolled 1016 patients: 36% underwent surgery for benign pathologies (mainly voluminous fibromatous uteri and severe deep endometriosis) and 64% for gynecologic malignancies. The overall complication rate was of 3.45%, the rate of major postoperative complications was 2.85%. A postoperative fibrinogen increase ≥ 20% had a high diagnostic accuracy to identify postoperative complications early (AUC 0.931, sensitivity 89%, and specificity 99%). The magnitude of postoperative fibrinogen change was associated with complication severity. Conclusions: Our findings demonstrated that fibrinogen increase can enable the early detection of postoperative complications after laparoscopic gynecological surgery. Further prospective and multi-center studies are warranted to confirm these results.

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Comparison of short-term outcomes and acute inflammatory response between laparoscopy-assisted and totally laparoscopic distal gastrectomy for early gastric cancer

Cited by 22 publications

References 25 publications

Laparoscopic Gastrectomy with Enhanced Recovery After Surgery Protocol: Single-Center Experience

Laparoscopic Gastrectomy with Enhanced Recovery After Surgery Protocol: Single-Center Experience

Safety and feasibility of laparoscopic gastrectomy accompanied by D1+ lymph node dissection for early gastric cancer in elderly patients

The utility of fibrinogen level as a predictor of complications after laparoscopic gynecologic surgery: a prospective observational study

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