Laparoscopic-assisted versus open total gastrectomy for Siewert type II and III esophagogastric junction carcinoma: a propensity score-matched case-control study

Huang, Chang‐Ming; Lv, Chen-Bin; Ji, Lin; Chen, Qi‐Yue; Zheng, Chao-Hui; Li, Ping; Xie, Jian‐Wei; Wang, Jia-Bin; Lü, Jun; Cao, Long‐Long; Ma, Lin; Tu, Ru‐Hong

doi:10.1007/s00464-016-5375-y

Cited by 31 publications

(41 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, the 3-year overall survival rate for patients with Siewert type II/III AEG was 63% after total gastrectomy using the new abdominal approach. Huang et al 33 confirmed that after laparoscopic-assisted total gastrectomy for AEG or open total gastrectomy, the 3-year overall survival rates of patients for AEG were not significantly different (72.0% versus 61.5%, respectively). As mentioned in some studies, total gastrectomy using the abdominal approach is used to treat advanced Siewert type III AEG.…”

Section: Discussionmentioning

confidence: 92%

Novel abdominal approach for dissection of advanced type II/III adenocarcinoma of the esophagogastric junction: a new surgical option

Zhu

et al. 2018

J Int Med Res

View full text Add to dashboard Cite

Objective The optimal surgical approach for Siewert type II adenocarcinoma of the esophagogastric junction (AEG) is controversial. In this study, we evaluated the outcomes of total gastrectomy for Siewert type II/III AEG via the left thoracic surgical approach that is used at our center. Methods We identified 41 patients with advanced AEG in our retrospective database and analyzed their 3-year survival rate, upper surgical margin, postoperative complications, and index of estimated benefit from lymph node dissection. Results The 3-year overall survival rate of the whole group was 63%, but no difference was observed between Siewert type II and III AEGs. Esophageal exposure and lymphadenectomy were sufficient. Eight patients developed postoperative complications, but none of the patients developed anastomotic leakage. Dissection of lymph node station Nos. 19 and 110 may be necessary for patients with Siewert type II AEG. Multivariate analysis revealed that the cT category was the only independent risk factor. Conclusions Total gastrectomy via an approach from the abdominal cavity into the thoracic cavity may be an optimal surgical technique for advanced Siewert type II AEG.

show abstract

Section: Discussionmentioning

confidence: 92%

Novel abdominal approach for dissection of advanced type II/III adenocarcinoma of the esophagogastric junction: a new surgical option

Zhu

et al. 2018

J Int Med Res

View full text Add to dashboard Cite

show abstract

“…The anastomotic leakage rate was almost the same in the 2 groups (approximately 4.5%). In China, Huang et al [16] demonstrated that the LA was associated with better short-term outcomes, including less blood loss and shorter hospitalization periods for Siewert types II and III AEJ compared with the OA. However, no significant differences were detected in the rate and severity of postoperative complications in Huang's study.…”

Section: Discussionmentioning

confidence: 99%

“…With regard to the lower mediastinal area, all lymph nodes can be visualized during dissection during the LA. Huang et al demonstrated a significantly increased number of retrieved lymph nodes and superior survival rates for Siewert type II AEJ [16] with the LA compared to the OA. However, the number of harvested lymph nodes did not differ between the LA and OA in the present study.…”

Section: Discussionmentioning

confidence: 99%

Long-term Outcomes of Laparoscopic Versus Open Transhiatal Approach for the Treatment of Esophagogastric Junction Cancer

et al. 2019

View full text Add to dashboard Cite

Purpose The laparoscopic transhiatal approach (LA) for adenocarcinoma of the esophagogastric junction (AEJ) is advantageous since it allows better visualization of the surgical field than the open approach (OA). We compared the surgical outcomes of the 2 approaches. Materials and Methods We analyzed 108 patients with AEJ who underwent transhiatal distal esophagectomy and gastrectomy with curative intent between 2003 and 2015. Surgical outcomes were reviewed using electronic medical records. Results The LA and OA were performed in 37 and 71 patients, respectively. Compared to the OA, the LA was associated with significantly shorter duration of postoperative hospital stay (9 vs. 11 days, P=0.001), shorter proximal resection margins (3 vs. 7 mm, P=0.004), and extended operative times (240 vs. 191 min, P=0.001). No significant difference was observed between the LA and OA for intraoperative blood loss (100 vs. 100 mL, P=0.392) or surgical morbidity rate (grade≥II) for complications (8.1% vs. 23.9%, P=0.080). Two cases of anastomotic leakage occurred in the OA group. The number of harvested lymph nodes was not significantly different between the LA and OA groups (54 vs. 51, P=0.889). The 5-year overall and 3-year relapse-free survival rates were 81.8% and 50.7% (P=0.024) and 77.3% and 46.4% (P=0.009) for the LA and OA groups, respectively. Multivariable analyses revealed no independent factors associated with overall survival. Conclusions The LA is feasible and safe with short- and long-term oncologic outcomes similar to those of the OA.

show abstract

“…After screening the title and abstract, 36 studies were assessed via full-text articles that we obtained. Finally, seven articles with a total of 1915 patients were included [13][14][15][16][17][18][19]. Approximately 1042 patients were in the LG group, while 873 patients were in the OG group.…”

Section: Selected Studiesmentioning

confidence: 99%

“…All selected studies reported the duration of surgery [13][14][15][16][17][18][19]. Four studies [15,16,18,19] showed that operative time was significantly longer in the LG group than in the OG group.…”

Section: Operative Timementioning

confidence: 99%

Laparoscopic versus open gastrectomy for Siewert type II/III adenocarcinoma of the esophagogastric junction: a meta-analysis

et al. 2020

View full text Add to dashboard Cite

Background The potential advantages of laparoscopic gastrectomy (LG) compared with open gastrectomy (OG) for Siewert type II/III adenocarcinoma of the esophagogastric junction (AEG) have not been fully clarified. The aim of this meta-analysis was to evaluate the safety and efficacy of LG for Siewert type II/III AEG, compared with OG. Methods A comprehensive search was performed in various medical databases up to December 30, 2018. Seven non-randomized controlled trials comparing LG and OG for Siewert type II/III AEG were included. Outcomes evaluated including operation time, estimated blood loss, number of retrieved lymph nodes (LNs), post-operation complications, postoperative hospital stay, time to first flatus, time to ambulation, and overall survival (OS). Results Seven studies of 1915 patients were included for meta-analysis. The estimated blood loss [weighted mean difference (WMD) = − 77.49, 95%CI − 111.84 to − 43.15; P < 0.00001] was significantly less and the postoperative hospital stay (WMD = − 1.98, 95%CI − 2.14 to − 1.83; P < 0.00001) was significantly shorter in the LG group than in the OG group, while the operation time, number of retrieved LNs, time to first flatus, and time to ambulation showed no significant difference between LG and OG groups. The overall postoperative complications [odds ratio (OR) 0.78, 95%CI 0.60-1.02; P = 0.07] in LG group were less than those in OG group, although the difference was not significant between the two groups. ConclusionLG can achieve short-term surgical outcomes comparable to OG, with respect to safety and efficiency in treatment of Siewert type II/III AEG.

show abstract

Laparoscopic-assisted versus open total gastrectomy for Siewert type II and III esophagogastric junction carcinoma: a propensity score-matched case-control study

Abstract: LATG is associated with better short-term outcomes for Siewert type II and III AEG. In addition, it may result in an increased number of retrieved LNs and better long-term survival for Siewert type II AEG patients in particular.

Cited by 31 publications

References 42 publications

Novel abdominal approach for dissection of advanced type II/III adenocarcinoma of the esophagogastric junction: a new surgical option

Novel abdominal approach for dissection of advanced type II/III adenocarcinoma of the esophagogastric junction: a new surgical option

Long-term Outcomes of Laparoscopic Versus Open Transhiatal Approach for the Treatment of Esophagogastric Junction Cancer

Laparoscopic versus open gastrectomy for Siewert type II/III adenocarcinoma of the esophagogastric junction: a meta-analysis

Contact Info

Product

Resources

About