Long- and short-term outcomes of laparoscopic gastrectomy versus open gastrectomy in patients with clinically and pathological locally advanced gastric cancer: a propensity-score matching analysis

Inokuchi, Mikito; Nakagawa, Masatoshi; Tanioka, Toshiro; Okuno, Keisuke; Gokita, Kentaro; Kojima, Kazuyuki

doi:10.1007/s00464-017-5730-7

Cited by 65 publications

(49 citation statements)

References 32 publications

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“…The objective of the present study was to analyse the practicability, safety and oncological quality of laparoscopic surgery for gastric cancer in a typical cohort of patients under conditions prevalent in the West, as well as to verify the reproducibility of data from Asia [10,12,18,19]. By comparison with Asian patients with similarly treated UICC stages, our patients were not only 5-10 years older on average, but also exhibited greater co-morbidity.…”

Section: Discussionmentioning

confidence: 89%

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Totally Laparoscopic versus Open Gastrectomy for Gastric Cancer: a Matched Pair Analysis

et al. 2018

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Section: Discussionmentioning

confidence: 89%

“…Anastomosis failure developed in 2 % of the LG group and in 6 % of the OG group. 30-day mortality was zero [18]. In a Chinese prospective randomised study with 519 LG and 520 OG, Hu et al recorded an overall morbidity of 14.9 % in the LG group and 12.9 % in the OG group (p = 0.314).…”

Section: Discussionmentioning

confidence: 96%

Totally Laparoscopic versus Open Gastrectomy for Gastric Cancer: a Matched Pair Analysis

et al. 2018

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“…What is more, conclusions from retrospective or prospective studies even meta-analyses [26, 27] concerning this topic were inconsistent. Some literature concluded that LADG was associated with a lower postoperative complication rate in AGC patients [26, 27]; others found no significant difference between LADG and ODG concerning postoperative morbidity [14, 28]. Even a meta-analysis reported by Cochrane Database considered that the evidence qualities of most completed or ongoing RCTs were low because of high risks of bias [29].…”

Section: Discussionmentioning

confidence: 99%

Short-term surgical outcomes of laparoscopy-assisted versus open D2 distal gastrectomy for locally advanced gastric cancer in North China: a multicenter randomized controlled trial

et al. 2018

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BackgroundAlthough laparoscopic surgery has been recommended as an optional therapy for patients with early gastric cancer, whether patients with locally advanced gastric cancer (AGC) could benefit from laparoscopy-assisted distal gastrectomy (LADG) with D2 lymphadenectomy remains elusive due to a lack of comprehensive clinical data. To evaluate the efficacy of LADG, we conducted a multi-institutional randomized controlled trial to compare laparoscopy-assisted versus open distal gastrectomy (ODG) for AGC in North China.MethodsIn this RCT, after patients were enrolled according to the eligibility criteria, they were preoperatively assigned to LADG or ODG arm randomly with a 1:1 allocation ratio. The primary endpoint was the morbidity and mortality within 30 postoperative days to evaluate the surgical safety of LADG. The secondary endpoint was 3-year disease-free survival. This trial was registered at ClinicalTrial.gov as NCT02464215.ResultsBetween March 2014 and August 2017, a total of 446 patients with cT2-4aN0-3M0 (AJCC 7th staging system) were enrolled. Of these, 222 patients underwent LADG and 220 patients underwent ODG were included in the modified intention-to-treat analysis. The compliance rate of D2 lymph node dissection was identical between the LADG and ODG arms (99.5%, P = 1.000). No significant difference was observed regarding the overall postoperative complication rate in two groups (LADG 13.1%, ODG 17.7%, P = 0.174). No operation-related death occurred in both arms.ConclusionsThis trial confirmed that LADG performed by credentialed surgeons was safe and feasible for patients with AGC compared with conventional ODG.

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“…Currently available data indicate that in addition to the advantages of minimally invasive surgery, such as rapid recovery, reduced blood loss, less pain, and fewer surgical site complications, laparoscopic gastric cancer surgery also provides acceptable oncological outcomes. [11][12][13][14][15][16] In our clinic, we try to utilize laparoscopic approaches in gastroenterologic cancer surgery as much as possible.…”

Section: Discussionmentioning

confidence: 99%

“…However, the diffi- culty of applying purse-string sutures to the esophagus during anvil placement in laparoscopic surgery is one of the reasons alternative methods have been sought. [15,21] The linear stapler technique may be difficult for inexperienced surgeons because it requires greater mobilization of the esophagus and suturing of the stapler entry site. However, advantages of this technique are that the linear stapler is more suitability for insertion through a trocar, and an experienced surgeon can perform the anastomosis more easily using a linear stapler than a circular stapler.…”

Section: Discussionmentioning

confidence: 99%

Early outcomes of laparoscopic total gastrectomy with hemi-double stapling technique in gastric cancer

Karagül¹

2019

Laparosc Endosc Surg Sci

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Introduction: The most difficult step of laparoscopic total gastrectomy for gastric cancer is esophagojejunostomy anastomosis. Although various techniques are recommended for this anastomosis, there is no standard method. This study aims to present the outcomes of our patients who underwent esophagojejunostomy using the hemi-double stapling technique (HDST). Materials and Methods: Patients who had laparoscopic surgery due to gastric cancer in our hospital between October 2016 and May 2019 were retrospectively analyzed. Patients who underwent laparoscopic total gastrectomy with HDST were included in this study. The patients' clinical characteristics and histopathological data were evaluated. Age, sex, body mass index (BMI), comorbidities, and American Society of Anesthesiologists (ASA) scores were documented. Operative time, intraoperative blood loss, specimen extraction site, day of oral intake, length of stay, postoperative complications, and mortality were evaluated. Results: A total of 13 patients (eight male, five female) were included in this study. The mean age was 63.3±15.8 years, and mean BMI was 26.4±6.8 kg/m 2. ASA score was ASA III in seven patients (54%), ASA II in three patients (23%), and ASA I in the remaining three patients (23%). Mean operative time was 222.7±39.6 minutes, and mean intraoperative blood loss was 97.3±52.4 mL. There were no complications related to esophagojejunostomy. A mean of 23.8±11.1 lymph nodes was removed, of which a mean of 10.8±11.9 were tumor-positive. Mean length of stay was 10.9±9.8 days, and mean follow-up was 10.1±7 months. Conclusion: HDST appears to be a safe method that can be used in the esophagojejunostomy step of laparoscopic total gastrectomy for gastric cancer.

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Long- and short-term outcomes of laparoscopic gastrectomy versus open gastrectomy in patients with clinically and pathological locally advanced gastric cancer: a propensity-score matching analysis

Abstract: LG can be a feasible treatment that is beneficial in terms of earlier recovery after operation and can be expected to result in similar survival as OG in patients with AGC.

Cited by 65 publications

References 32 publications

Totally Laparoscopic versus Open Gastrectomy for Gastric Cancer: a Matched Pair Analysis

Totally Laparoscopic versus Open Gastrectomy for Gastric Cancer: a Matched Pair Analysis

Short-term surgical outcomes of laparoscopy-assisted versus open D2 distal gastrectomy for locally advanced gastric cancer in North China: a multicenter randomized controlled trial

Early outcomes of laparoscopic total gastrectomy with hemi-double stapling technique in gastric cancer

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