Short‐term clinical outcomes of laparoscopic gastrectomy for remnant gastric cancer: A single‐institution experience and systematic review of the literature

Abstract

Aim Application of laparoscopic approaches for the treatment of remnant gastric cancers (RGC) is still controversial. Therefore, in the present study, the safety and effectiveness of laparoscopic gastrectomy (LG) for RGC was investigated. Methods A total of 27 patients who underwent gastrectomy for RGC from June 2008 to September 2017 were enrolled in this study. A comprehensive review of the literature on LG for RGC published before December 2017 using the PubMed database was carried out. Results Laparoscopic gastrectomy was carried out in seven patients, and open gastrectomy (OG) was done in the remaining 20 patients. LG was associated with significantly less intraoperative blood loss (70 ± 71 vs. 1066 ± 1428 g; P < 0.001), significantly more retrieved lymph nodes (22 ± 13 vs. 12 ± 9; P = 0.03), a relatively lower postoperative complication rate, and a relatively shorter postoperative hospital stay than OG. A comprehensive review of the literature showed that LG for RGC was more likely to correlate with longer operative time, less blood loss, lower postoperative complication rate, shorter postoperative hospital stay, and more retrieved lymph nodes than OG. Conclusion The clinical outcome of our patients with RGC and the literature indicated that a laparoscopic approach contributed to faster recovery after surgery than an open approach without sacrificing its radicality and was a safe and secure treatment option for RGC.

Laparoscopic Completion total Gastrectomy as an Alternative Procedure for Gastric Stump Cancer: A Case Control Study

“…Many surgeons have successfully applied LCTG, and this technique is considered the preferred treatment option (Table 5) [24][25][26][27][28][29][30][31][32][33]. As shown in Table 6, our results are consistent with those of comparative studies [14][15][16][17][18][19][20][21]. The patients in the LCTG group had smaller tumor size, lower numbers of metastatic lymph nodes, and lower pathological stages than patients in the OCTG group; however, the clinical stage distribution, dissection, and retrieved lymph nodes showed no signi cant differences between the groups.…”

“…The patients in the LCTG group had smaller tumor size, lower numbers of metastatic lymph nodes, and lower pathological stages than patients in the OCTG group; however, the clinical stage distribution, dissection, and retrieved lymph nodes showed no signi cant differences between the groups. Additionally, the number of retrieved lymph nodes was equal to that reported in other studies (Table 6) [14][15][16][17][18][19][20][21]. The OCTG group had a higher number of recurrences and deaths than the LCTG group, because the OCTG group had more advanced cases, leading to a worse 5-year overall survival rate than the LCTG group.…”

“…Laparoscopic gastrectomy has been con rmed to be safe with improved postoperative pain and earlier recovery than open gastrectomy [11][12][13]. However, only a few studies have reported the feasibility of laparoscopic completion total gastrectomy (LCTG) for GSC [14][15][16][17][18][19][20][21]. This study aimed to evaluate the feasibility, safety, and clinical outcomes of LCTG compared with those of open completion total gastrectomy (OCTG) to prove the oncological validity of LCTG.…”

Laparoscopic Total Gastrectomy for Remnant Gastric Cancer: A Single-institution Experience and Systematic Literature Review

“…Six studies reported that the conversion rate to open gastrectomy was 5.6-47.1%; the other 15 studies reported no cases of conversion to open gastrectomy. In all studies, the mean operation time ranged from 197 to 487 min, the mean blood loss was up to 425 g, the mean number of retrieved lymph nodes ranged from 7 to 26 and the mean duration of postoperative hospital stay (18)(19)(20)(21)(22)(23)(24). Among these 8 studies, 6 studies showed that LTG was associated with less blood loss, 4 studies showed that LTG was associated with a longer operation time, and 1 study showed that LTG was associated with a greater number of retrieved lymph nodes and shorter postoperative hospital stay in comparison to the OTG group.…”

Current controversies in treating remnant gastric cancer: Are minimally invasive approaches feasible?

“…All studies comparing the operating time between OG and LG reported that LG required more time than OG, even though the difference was not statistically significant in five out of the ten studies[64-66,68,69]. However, LG was associated with lower intraoperative blood loss than OG in six of the ten studies[60,61,65,66,68,69]. The number of resected lymph nodes was reported in all non-RCTs and case studies.…”