Postoperative Outcomes of Minimally Invasive Gastrectomy Versus Open Gastrectomy During the Early Introduction of Minimally Invasive Gastrectomy in the Netherlands

Brenkman, Hylke J. F.; Gisbertz, Suzanne S.; Slaman, Annelijn E.; Goense, Lucas; Ruurda, Jelle P.; Henegouwen, Mark I. van Berge; Hillegersberg, Richard van

doi:10.1097/sla.0000000000002391

Cited by 63 publications

(60 citation statements)

References 21 publications

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“…The difference was mainly caused by the decrease in local complications, not by systemic complications; in particular, the incidence of fluid collection and intra-abdominal bleeding was significantly lower with laparoscopic gastrectomy than with open surgery. The postoperative morbidity rates of laparoscopic gastrectomy range from 6.4 % to 24.2 % [5,11,12,15,16,24]. In the current study, the morbidity rate was 16%, which is within the range reported previously, indicating that the morbidity rate in our study is satisfactory.…”

Section: Discussionsupporting

confidence: 85%

“…On the other hand, the reoperation rate in our study was better than that of a study in Italy, which reported a reoperation rate of 9.52% [27]. According to the literature, mortality rates range from 0% to 6% [5,11,22,24]. In our study, there were two mortalities (8%), which is slightly higher than in previous studies.…”

Section: Discussioncontrasting

confidence: 78%

“…Anastomotic leakage, which is considered a major complication of gastric surgery, should be evaluated appropriately. Anastomotic leakage rates from previous studies range from 0.2% to 14% [3,5,11,12,22,24]. In our study, anastomotic leakage occurred in one case (4%) of total gastrectomy, which is within the range of other studies.…”

Section: Discussionsupporting

confidence: 76%

“…Eastern studies reported a conversion rate ranging from 2.2% to 7% [3,5,11,12,18,28]. On the other hand, Ecker et al [20] and Brenkman et al [24] reported conversion rates of 23.9% and 10%, respectively. In the present study, the conversion rate was 28%, which is significantly higher than that of other studies; however, the reason may be that most of these studies conducted D1 rather than D2 lymphadenectomy.…”

Section: Discussionmentioning

confidence: 97%

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Laparoscopic gastrectomy with D2 lymphadenectomy for gastric cancer: initial Egyptian experience at the National Cancer Institute

Abdelhamed

Abdellatif

Touny

et al. 2020

J Egypt Natl Canc Inst

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Background: Laparoscopic gastrectomy has been used as a superior alternative to open gastrectomy for the treatment of early gastric cancer. However, the application of laparoscopic D2 lymphadenectomy remains controversial. This study aimed to evaluate the feasibility and outcomes of laparoscopic gastrectomy with D2 lymphadenectomy for gastric cancer. Results: Between May 2016 and May 2018, twenty-five consecutive patients with gastric cancer underwent laparoscopic D2 gastrectomy: eighteen patients (72%) underwent distal gastrectomy, four patients (16%) underwent total gastrectomy, and three patients (12%) underwent proximal gastrectomy. The median number of lymph nodes retrieved was 18 (5-35). A positive proximal margin was detected in 2 patients (8%). The median operative time and amount of blood loss were 240 min (200-330) and 250 ml (200-450), respectively. Conversion to an open procedure was performed in seven patients (28%). The median hospital stay period was 8 days (6-30), and the median time to start oral fluids was 4 days (3-30). Postoperative complications were detected in 4 patients (16%). There were two cases of mortality (8%) in the postoperative period, and two patients required reoperation (8%). Conclusions: Laparoscopic gastrectomy with D2 lymphadenectomy can be carried out safely and in accordance with oncologic principles.

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Section: Discussionsupporting

confidence: 85%

Section: Discussioncontrasting

confidence: 78%

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 97%

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Laparoscopic gastrectomy with D2 lymphadenectomy for gastric cancer: initial Egyptian experience at the National Cancer Institute

Abdelhamed

Abdellatif

Touny

et al. 2020

J Egypt Natl Canc Inst

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“…In parallel, the proportion of laparoscopic resections has increased in some European countries. Thus, in a population-based study conducted in hospitals in the Netherlands, Brenkman et al 2017 reported that the percentage of laparoscopic gastric resections had increased from 4 % in 2011 to 53 % in 2015 [16].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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Cost-effectiveness of Laparoscopic vs Open Gastrectomy for Gastric Cancer

et al. 2023

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ImportanceLaparoscopic gastrectomy is rapidly being adopted worldwide as an alternative to open gastrectomy to treat gastric cancer. However, laparoscopic gastrectomy might be more expensive as a result of longer operating times and more expensive surgical materials. To date, the cost-effectiveness of both procedures has not been prospectively evaluated in a randomized clinical trial.ObjectiveTo evaluate the cost-effectiveness of laparoscopic compared with open gastrectomy.Design, Setting, and ParticipantsIn this multicenter randomized clinical trial of patients undergoing total or distal gastrectomy in 10 Dutch tertiary referral centers, cost-effectiveness data were collected alongside a multicenter randomized clinical trial on laparoscopic vs open gastrectomy for resectable gastric adenocarcinoma (cT1-4aN0-3bM0). A modified societal perspective and 1-year time horizon were used. Costs were calculated on the individual patient level by using hospital registry data and medical consumption and productivity loss questionnaires. The unit costs of laparoscopic and open gastrectomy were calculated bottom-up. Quality-adjusted life-years (QALYs) were calculated with the EuroQol 5-dimension questionnaire, in which a value of 0 indicates death and 1 indicates perfect health. Missing questionnaire data were imputed with multiple imputation. Bootstrapping was performed to estimate the uncertainty surrounding the cost-effectiveness. The study was conducted from March 17, 2015, to August 20, 2018. Data analyses were performed between September 1, 2020, and November 17, 2021.InterventionsLaparoscopic vs open gastrectomy.Main Outcomes and MeasuresEvaluations in this cost-effectiveness analysis included total costs and QALYs.ResultsBetween 2015 and 2018, 227 patients were included. Mean (SD) age was 67.5 (11.7) years, and 140 were male (61.7%). Unit costs for initial surgery were calculated to be €8124 (US $8087) for laparoscopic total gastrectomy, €7353 (US $7320) for laparoscopic distal gastrectomy, €6584 (US $6554) for open total gastrectomy, and €5893 (US $5866) for open distal gastrectomy. Mean total costs after 1-year follow-up were €26 084 (US $25 965) in the laparoscopic group and €25 332 (US $25 216) in the open group (difference, €752 [US $749; 3.0%]). Mean (SD) QALY contributions during 1 year were 0.665 (0.298) in the laparoscopic group and 0.686 (0.288) in the open group (difference, −0.021). Bootstrapping showed that these differences between treatment groups were relatively small compared with the uncertainty of the analysis.Conclusions and RelevanceAlthough the laparoscopic gastrectomy itself was more expensive, after 1-year follow-up, results suggest that differences in both total costs and effectiveness were limited between laparoscopic and open gastrectomy. These results support centers’ choosing, based on their own preference, whether to (de)implement laparoscopic gastrectomy as an alternative to open gastrectomy.

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Postoperative Outcomes of Minimally Invasive Gastrectomy Versus Open Gastrectomy During the Early Introduction of Minimally Invasive Gastrectomy in the Netherlands

Abstract: MIG was safely introduced in the Netherlands, with overall morbidity and mortality comparable with OG, less wound complications and shorter hospitalization.

Cited by 63 publications

References 21 publications

Laparoscopic gastrectomy with D2 lymphadenectomy for gastric cancer: initial Egyptian experience at the National Cancer Institute

Laparoscopic gastrectomy with D2 lymphadenectomy for gastric cancer: initial Egyptian experience at the National Cancer Institute

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

Cost-effectiveness of Laparoscopic vs Open Gastrectomy for Gastric Cancer

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