Feasibility of laparoscopy-assisted total gastrectomy in patients with clinical stage I gastric cancer

Wada, Noriko; Kurokawa, Yukinori; Takiguchi, Shuji; Takahashi, Tsuyoshi; Yamasaki, Makoto; Miyata, Hiroshi; Nakajima, Kiyokazu; Mori, Masaki; Doki, Yuichiro

doi:10.1007/s10120-013-0235-0

Cited by 57 publications

(47 citation statements)

References 22 publications

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“…By contrast, one study showed a high incidence of anastomosis-related complications in the LTG group [52]. Pancreatic fistula is another important complication to be considered when performing LTG [20,24]. The incidence of pancreatic fistula did not differ between the LTG and OTG groups.…”

Section: Postoperative Complicationsmentioning

confidence: 93%

“…It is therefore difficult to assess the course of postoperative recovery in retrospective studies. In most studies, mortality was low and acceptable, with no significant differences between different patient groups [18][19][20][21][22][23][24].…”

Section: Postoperative Recoverymentioning

confidence: 98%

“…Although ten LTGs were included in this study, this was not regarded as the first report, because of its small sample size and because the results were collected by a questionnaire. Since LTG was first reported as a technical note in 1999 [26], some further studies have been reported [18][19][20][21][22][23][24]. Of these, the highest number of publications has been from Japan (n = 50), followed by Korea (n = 42; see Fig.…”

Section: Annual Publicationsmentioning

confidence: 99%

“…Recently, laparoscopic total gastrectomy (LTG), also known as laparoscopy-assisted total gastrectomy and which is a more complex surgical procedure, has been more frequently used, and its outcomes are beginning to be reported [18][19][20][21]. Moreover, new techniques for LTG, in which intracorporeal esophagojejunostomy can be performed completely laparoscopically, have been developed in some high-volume centers, and some shortterm outcomes have been reported [22][23][24].…”

Section: Introductionmentioning

confidence: 99%

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A systematic review of laparoscopic total gastrectomy for gastric cancer

et al. 2015

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Background Laparoscopic total gastrectomy (LTG) has been performed since 1999. Although surgical outcomes have been reported from Japan, Korea, China, and many Western countries, the effectiveness of this technique has not been conclusively established. This study therefore aimed to review the literature systematically. Methods Our search of the research literature identified 150 studies, which were mostly retrospective and from single institutions. Results There has recently been a remarkable increase in the number of studies from Korea, and the number of patients included in studies has increased since 2009. In most studies, the surgical procedures were longer, blood loss was reduced, and the number of retrieved lymph nodes was the same in the LTG group as in the open total gastrectomy group. The incidence of postoperative complications and that of inflammation during postoperative recovery were the same in these two groups. Conclusions During LTG, the method used for esophagojejunostomy is important for surgical reliability and to reduce postoperative complications. There has been rapid development of new techniques from the level of esophagojejunostomy through a small skin incision to the high level of intracorporeal esophagojejunostomy using various techniques. A nationwide prospective phase II study is urgently needed to establish the value of LTG.

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Section: Postoperative Complicationsmentioning

confidence: 93%

Section: Postoperative Recoverymentioning

confidence: 98%

Section: Annual Publicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A systematic review of laparoscopic total gastrectomy for gastric cancer

et al. 2015

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“…The pneumoperitoneum was vulnerable to its placement, and vision was unclear. Therefore, it was not an ideal method and may have resulted in a higher rate of postoperative complications [14,15] , especially in our early experience. Thus, a novel transorally inserted anvil (OrVil; Covidien, Mansfield, MA, United States) was introduced to address the challenge of anvil placement [16] .…”

Section: Discussionmentioning

confidence: 99%

Intracorporeal esophagojejunostomy after totally laparoscopic total gastrectomy: A single-center 7-year experience

Chen

Pan

Cai

et al. 2016

WJG

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AIM:To assess the efficacy and safety of intracorporeal esophagojejunostomy in patients undergoing laparoscopic total gastrectomy (LTG) for gastric cancer. METHODS:A retrospective review of 81 consecutive patients who underwent LTG with the same surgical team between November 2007 and July 2014 was performed. Four types of intracorporeal esophagojejunostomy using staplers or hand-sewn suturing were performed after LTG. Data on clinicopatholgoical characteristics, occurrence of complications, postoperative recovery, anastomotic time, and operation time among the surgical groups were obtained through medical records. RESULTS:The average operation time was 288.7 min, the average anastomotic time was 54.3 min, and the average estimated blood loss was 82.7 mL. There were no cases of conversion to open surgery. The first flatus was observed around 3.7 d, while the liquid diet was started, on average, from 4.9 d. The average postoperative hospital stay was 10.1 d. Postoperative complications occurred in 14 patients, nearly 17.3%. Observational Study ORIGINAL ARTICLEHowever, there were no cases of postoperative death.CONCLUSION: LTG performed with intracorporeal esophagojejunostomy using laparoscopic staplers or hand-sewn suturing is feasible and safe. The surgical results were acceptable from the perspective of minimal invasiveness.

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Morbidity and Mortality of Laparoscopic vs Open Total Gastrectomy for Clinical Stage I Gastric Cancer

et al. 2020

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IMPORTANCEThe safety of laparoscopic total gastrectomy (LTG) for the treatment of gastric cancer remains uncertain given the lack of high-level clinical evidence.OBJECTIVE To compare the safety of LTG for clinical stage I gastric cancer with that of conventional open total gastrectomy (OTG). DESIGN, SETTING, AND PARTICIPANTSThe Chinese Laparoscopic Gastrointestinal Surgery Study (CLASS) Group CLASS02 study was a prospective, multicenter, open-label, noninferiority, randomized clinical trial that compared the safety of LTG vs OTG with lymphadenectomy for patients with clinical stage I gastric cancer. From January 2017 to September 2018, a total of 227 patients were enrolled. Final follow-up was in October 2018. INTERVENTIONS Eligible patients were randomized to LTG (n = 113) or OTG (n = 114) by an interactive web response system. MAIN OUTCOMES AND MEASURESThe primary outcome was the morbidity and mortality within 30 days following surgeries between LTG and OTG with a noninferiority margin of 10%. The secondary outcomes were recovery courses and postoperative hospital stays.RESULTS A total of 214 patients were analyzed for morbidity and mortality (105 patients in the LTG group and 109 patients in the OTG group). The mean (SD) age was 59.8 (9.4) years in the LTG group and 59.4 (9.2) years in the OTG group, and most were male (LTG group, 75 of 105 [71.4%]; OTG group, 80 of 109 [73.4%]). The overall morbidity and mortality rates were not significantly different between the groups (rate difference, −1.1%; 95% CI, −11.8% to 9.6%). Intraoperative complications occurred in 3 patients (2.9%) in the LTG group and 4 patients (3.7%) in the OTG group (rate difference, −0.8%; 95% CI, −6.5% to 4.9%). In addition, there was no significant difference in the overall postoperative complication rate of 18.1% in the LTG group and 17.4% in the OTG group (rate difference, 0.7%; 95% CI, −9.6% to 11.0%). One patient in the LTG group died from intra-abdominal bleeding secondary to splenic artery hemorrhage. However, there was no significant difference in mortality between the LTG group and the OTG group (rate difference, 1.0%; 95% CI, −2.5% to 5.2%), and the distribution of complication severity was similar between the 2 groups. CONCLUSIONS AND RELEVANCEThe results of the CLASS02 trial showed that the safety of LTG with lymphadenectomy by experienced surgeons for clinical stage I gastric cancer was comparable to that of OTG.

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Feasibility of laparoscopy-assisted total gastrectomy in patients with clinical stage I gastric cancer

Cited by 57 publications

References 22 publications

A systematic review of laparoscopic total gastrectomy for gastric cancer

A systematic review of laparoscopic total gastrectomy for gastric cancer

Intracorporeal esophagojejunostomy after totally laparoscopic total gastrectomy: A single-center 7-year experience

Morbidity and Mortality of Laparoscopic vs Open Total Gastrectomy for Clinical Stage I Gastric Cancer

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