Short-term surgical outcomes and operative risks of laparoscopic total gastrectomy (LTG) for gastric carcinoma: experience at a large-volume center

Jeong, Oh; Ryu, Sun-Youl; Zhao, Xue-Feng; Jung, Mi Ran; Kim, Kwang‐Yong; Park, Young Kyu

doi:10.1007/s00464-012-2356-7

Cited by 61 publications

(49 citation statements)

References 28 publications

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“…We have performed LATG with the purse-string suture anastomosis in 100 patients with clinical stage I gastric cancer. Compared with the previous Korean studies and a small-scale Japanese study evaluating the safety of LATG [5,6,12, 13], we were able to perform LATG with more favorable surgical results in terms of operation time. Regarding the incidence of postoperative complications, our study showed better or similar results compared to previous studies of LATG.…”

Section: Discussionmentioning

confidence: 71%

“…The reconstruction required in LATG is technically much more difficult than that in LADG. Only a few Korean studies have evaluated the feasibility of LATG with more than 100 patients [5,6], so the safety of LATG is still controversial. We have performed LATG with the purse-string suture anastomosis on 100 patients with clinical stage I gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of laparoscopy-assisted total gastrectomy in patients with clinical stage I gastric cancer

et al. 2013

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Background Laparoscopy-assisted total gastrectomy (LATG) for gastric cancer is not yet widespread because of the technical difficulty of reconstruction. We have performed LATG on 100 patients with clinical stage I gastric cancer. This study investigated the short-term outcomes of LATG. Methods Between September 2001 and September 2012, 100 patients with clinical stage I gastric cancer underwent LATG with D1 plus beta or D2 lymphadenectomy. Roux-en-Y esophagojejunostomy was performed intracorporeally using end-to-side anastomosis with a circular stapler (the purse-string suture method). The primary endpoint was the proportion of postoperative complications during hospitalization. Results Mean operation time was 249 min; mean blood loss was 182 ml. There were no conversions to open surgery. According to the Clavien-Dindo classification, there were 8 grade II (8 %) and 10 grade IIIa/b (10 %) complications. There were no treatment-related deaths or grade IV complications. The most frequent complication was anastomotic or stump leakage (6 %), followed by pancreatic fistula (5 %). Reoperations were required in two patients with leakage. Conclusions The short-term outcomes of LATG in our study involving 100 patients were outlined. LATG for gastric cancer patients should be attempted preferably in a clinical trial setting by surgeons with sufficient experience in laparoscopic gastrectomy.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Feasibility of laparoscopy-assisted total gastrectomy in patients with clinical stage I gastric cancer

et al. 2013

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“…The surgical procedure for CLATG is more complex and challenging than that for laparoscopic distal gastrectomy, even for an experienced gastric surgeon. In particular, the reconstruction technique has not yet been well established in CLATG [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…However, laparoscopy-assisted total gastrectomy (LATG) has not been widely used for the treatment of gastric cancer because of its technical difficulty and complexity, including the reconstruction required and its oncological safety. The most important issue that needs to be resolved is the technique used for the reconstruction of an esophagojejunostomy during LATG [9,10].…”

Section: Introductionmentioning

confidence: 99%

Application of reduced-port laparoscopic total gastrectomy in gastric cancer preserving the pancreas and spleen

et al. 2014

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Background The feasibility of using reduced-port laparoscopic total gastrectomy (RPLTG) for the treatment of gastric cancer remains unclear. This study aimed to address the potentially important advantages of this surgical technique. Methods Between April 2002 and February 2014, 90 patients underwent laparoscopy-assisted total gastrectomies, performed by a single surgeon. Of these, 45 patients underwent RPLTG and 45 patients underwent conventional laparoscopy-assisted total gastrectomy (CLATG). Shortterm outcomes were compared to evaluate the feasibility of RPLTG for gastric cancer. Results There were several significant differences between the RPLTG and CLATG groups in short-term outcomes: the mean total operation durations were significantly longer in the RPLTG group (319.0 min) than in the CLATG group (259.0 min). However, the mean volume of blood loss, the degree of lymph node dissection, and the number of dissected lymph nodes did not differ between the two groups. Conclusions We have shown that RPLTG could be an acceptable and satisfactory procedure for the treatment of gastric cancer requiring total gastrectomy for surgeons sufficiently experienced in CLATG.

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“…In a series of 118 laparoscopic total gastrectomies, male gender was independently associated with postoperative morbidity [15] . Overweight patients [i.e., body mass index (BMI) > 25 kg/m 2 ] are at an increased risk of complications; this was shown in a large prospective series of 1853 patients [16] .…”

Section: Surgical Risk Assessmentmentioning

confidence: 99%

Improving the outcomes in gastric cancer surgery

Tegels¹,

Maat²,

Hulsewé³

et al. 2014

WJG

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Short-term surgical outcomes and operative risks of laparoscopic total gastrectomy (LTG) for gastric carcinoma: experience at a large-volume center

Abstract: LTG is a feasible and acceptable procedure for treatment of middle or upper early gastric cancer. Further refinement of anastomosis techniques and considerable experience of laparoscopic gastrectomy are required for proper application of LTG in gastric carcinoma.

Cited by 61 publications

References 28 publications

Feasibility of laparoscopy-assisted total gastrectomy in patients with clinical stage I gastric cancer

Feasibility of laparoscopy-assisted total gastrectomy in patients with clinical stage I gastric cancer

Application of reduced-port laparoscopic total gastrectomy in gastric cancer preserving the pancreas and spleen

Improving the outcomes in gastric cancer surgery

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