Short-term outcomes and nutritional status after laparoscopic subtotal gastrectomy with a very small remnant stomach for cStage I proximal gastric carcinoma

Furukawa, H; Kurokawa, Yukinori; Takiguchi, Shuji; Tanaka, Koji; Miyazaki, Yasuhiro; Makino, Tomoki; Takahashi, Tsuyoshi; Yamasaki, Makoto; Nakajima, Kiyokazu; Mori, Masaki; Doki, Yuichiro

doi:10.1007/s10120-017-0755-0

Cited by 56 publications

(63 citation statements)

References 39 publications

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“…Several studies have found that proximal gastrectomy has little benefit over total gastrectomy in terms of nutrition and weight loss [8,9]. Considering these data, laparoscopic subtotal gastrectomy (LsTG) with a very small remnant stomach has been also performed for upper-third EGC; several studies have shown this procedure has surgical and nutritional benefits over LPG or LTG [10,11].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have reported that LsTG is suitable for ECG in the upper-third of the stomach as far as safety and nutritional aspects are concerned [10,11]. However, oncological problems to be considered with LsTG include a possible insufficient proximal margin because of the proximity to the cardia and risks of inadequate lymph node dissection, especially failure to dissect stations no.…”

Section: Introductionmentioning

confidence: 99%

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Oncological feasibility of laparoscopic subtotal gastrectomy compared with laparoscopic proximal or total gastrectomy for cT1N0M0 gastric cancer in the upper gastric body

et al. 2019

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Background The upper gastric body is of particular interest in relation to gastrectomy because this area includes a border; that is, both distal and proximal gastrectomy for early gastric cancer can involve this area. Laparoscopic subtotal gastrectomy (LsTG) is reported to be suitable procedure compared with laparoscopic proximal and total gastrectomy (LPG, LTG), regarding postoperative nutritional status and surgical safety. However, whether LsTG is an oncologically acceptable procedure for early gastric cancer in the upper gastric body is unclear. Methods We analyzed 215 patients with cT1N0M0 gastric cancer limitedly located in the upper gastric body. The frequency of conversion from each intended procedure to an alternative procedure, the width of the pathological margin, the incidence of lymph node metastasis at each station and the 3-year overall survival (OS) and relapse-free survival (RFS) were evaluated. Results LsTG was planned for 65 patients, and LPG for 72 and LTG for 78, respectively. Conversion to other procedures was required in about 10% of patients for whom LsTG or LPG was planned. The width of the pathological margin in patients who underwent LsTG was significantly shorter than patients who underwent the others. No patients who underwent LsTG, LPG or LTG had metastases in station no. 2 or 4sa lymph node. The 3-year OS and RFS rates of patients for whom each procedure was planned were not different. Conclusions LsTG could be an oncologically acceptable procedure for cT1N0M0 gastric cancer in the upper gastric body. LsTG could be one option for such disease.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Oncological feasibility of laparoscopic subtotal gastrectomy compared with laparoscopic proximal or total gastrectomy for cT1N0M0 gastric cancer in the upper gastric body

et al. 2019

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“…Less invasive procedures, such as local limited gastrectomy [40] and endoscopic resection [41], might be medically appropriate for frail patients, given that the relapse rate is extremely low and that the risk of non-GC related death is very high in this population [42]. Furthermore, preserving even a very small functional stomach is advisable for older patients [43] since TG Fig. 4.…”

Section: Variablesmentioning

confidence: 99%

“…(b) In the low pre-PNI group, OS rates did not differ significantly between the two groups (P = .27). reportedly has many nutritional disadvantages [43] and the risk of non-GC-related death is also increased in the older. Accordingly, perioperative PNI might facilitate identifying good candidates for nutritional interventions and tailoring optimal treatment strategies for these patients, although whether PNI is suitable for validating short-term changes in nutritional and physical status should be carefully considered [44].…”

Section: Variablesmentioning

confidence: 99%

Pre- and post-operative low prognostic nutritional index influences survival in older patients with gastric carcinoma

Sugawara

Aikou

Yajima

et al. 2020

Journal of Geriatric Oncology

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“…After screening the title and abstract, 49 studies were evaluated via full-text articles. At last, seven articles [7,[12][13][14][15][16][17] published were included for quantitative synthesis from 2016 to 2018. The flow diagram were summarized is shown in Fig.…”

Section: Literature Searchmentioning

confidence: 99%

A meta-analysis of comparison of proximal gastrectomy with double-tract reconstruction and total gastrectomy for proximal early gastric cancer

Shen

et al. 2019

Preprint

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Background In theory, proximal gastrectomy with double-tract reconstruction (PG-DT) was superior to total gastrectomy (TG) in hematologic and nutritional outcomes. However, its clinical effects in proximal early gastric cancer (EGC) have been controversial. Methods The purpose of this study was to investigate the outcomes of laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DT) for proximal EGC. For this systematic review and meta-analysis, we searched for articles published before December of 2018 in the following databases: PubMed, Web of Science, EBSCO, Medline, and Cochrane Library. Results The results showed no significant difference in the anastomotic stenosis (OR=0.91, 95%CI=0.33-2.50, p=0.85) and reflux esophagitis (OR=1.87, 95%CI=0.62-5.65, p=0.27) between LPG-DT and laparoscopic total gastrectomy (LTG). The vitamin B12 supplementation rate in the LPG-DT group was lower than the LTG group (OR=0.06, 95%Cl=0.01-0.59, p=0.02). Conclusions Due to comparable clinical effect, PG-DT is comparable to TG for patients with proximal EGC. In addition, LPG-DT not only appears superior to TG in terms of preventing vitamin B12 deficiency, but also does not increase the risk of anastomotic stricture and reflux esophagitis.

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Short-term outcomes and nutritional status after laparoscopic subtotal gastrectomy with a very small remnant stomach for cStage I proximal gastric carcinoma

Abstract: LsTG with a very small remnant stomach had favorable short-term outcomes and nutritional status compared with LTG and LPG, so it may be a better treatment option for cStage I proximal gastric carcinoma.

Cited by 56 publications

References 39 publications

Oncological feasibility of laparoscopic subtotal gastrectomy compared with laparoscopic proximal or total gastrectomy for cT1N0M0 gastric cancer in the upper gastric body

Oncological feasibility of laparoscopic subtotal gastrectomy compared with laparoscopic proximal or total gastrectomy for cT1N0M0 gastric cancer in the upper gastric body

Pre- and post-operative low prognostic nutritional index influences survival in older patients with gastric carcinoma

A meta-analysis of comparison of proximal gastrectomy with double-tract reconstruction and total gastrectomy for proximal early gastric cancer

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