Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer: early and long-term results of a 100-patient series

Hüscher, C; Mingoli, Andrea; Sgarzini, Giovanna; Brachini, Gioia; Binda, Barbara; Paola, M. Di; Ponzano, Cecilia

doi:10.1016/j.amjsurg.2007.08.037

Cited by 97 publications

(71 citation statements)

References 29 publications

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“…These prudent manipulations might be helpful to prevent seeding of tumor cells if focal serosal invasion is suspected. In the present study, the peritoneal recurrence was not higher than in another report, and there was no portsite recurrence [23,24].…”

Section: Discussioncontrasting

confidence: 67%

“…In the present study for treating patients with AGC, though a small number of cases were stratified for each stage, patients who had tumor invading into the serosa (T3) as well as into the subserosa (T2b) did not show worse survival or recurrence rates compared with other reports [23][24][25]. Especially, among 86 T2 tumors, the overall survival and disease-free survival rates were both 100% in patients with T2a tumors and they were 84.1% and 71.6% in patients with T2b tumors, respectively.…”

Section: Discussionmentioning

confidence: 63%

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Long‐term outcomes after laparoscopy‐assisted gastrectomy for advanced gastric cancer: Analysis of consecutive 106 experiences

Lee

Kim

2009

Journal of Surgical Oncology

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Background and Objectives: The purpose of this retrospective study is to suggest the possibility of laparoscopy-assisted gastrectomy (LAG) for advanced gastric cancer (AGC) through long-term outcomes. Methods: Of 283 patients with gastric cancer who underwent LAG with extraperigastric (D2) lymphadenectomy between January 2004 and February 2009, 106 were pathologically confirmed with AGC and analyzed. Results: There were 75 men and 31 women, with a mean age of 61.4 AE 11.7 years. There were 32 total gastrectomies and 74 distal gastrectomies with D2 lymphadenectomy. The mean tumor size was 4.8 AE 2.6 cm. The mean numbers of retrieved and metastatic lymph nodes were 34.3 AE 15.3 and 5.4 AE 8.7, respectively. There was no lymph node metastasis in 44 patients (41.5%), and there were 35 grade T2a, 51 T2b, and 20 T3 lesions. There were 10 operation-related morbidities (9.4%) and one postoperative death (0.9%) from hepatic failure. The overall and disease-free survival rates were 81.4% and 72.4%, respectively. Tumors recurred in 17 patients (16.0%) during the follow-up periods (median 21.5 months; range 2-60). Conclusions: LAG for AGC might be considered as a minimally invasive treatment in selected cases, but further study comparing it with open gastrectomy will be needed.

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Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 63%

Long‐term outcomes after laparoscopy‐assisted gastrectomy for advanced gastric cancer: Analysis of consecutive 106 experiences

Lee

Kim

2009

Journal of Surgical Oncology

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“…To make a definitive conclusion about this suggestion, an assessment of quality of life (including mental status) would be required. Furthermore, laparoscopic total gastrectomy is widely recognized as a less invasive surgery, but it is unknown whether RPS for total gastrectomy is less invasive than conventional laparoscopic gastrectomy [21][22][23][24][25]. Also, lately, procedures using 2 or 3 mm diameter forceps are gradually increasing in popularity for various surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…However, this would not be advantageous if the operation time was much longer or the amount of blood loss was much greater than those associated with C-LATG. The reported operation time, blood loss, and number of dissected lymph nodes in C-LATG were 187-304 min, 10-334 mL, and 26-48.5, respectively [21][22][23][24][25]. Our results for the operation time (253.0 ± 26.8 min), blood loss (33.4 ± 23.7 mL), and the number of dissected lymph nodes (31.6 ± 12.3) were within the ranges reported for C-LATG [21,22,25].…”

Section: Discussionmentioning

confidence: 99%

The initial experience of dual port laparoscopy-assisted total gastrectomy as a reduced port surgery for total gastrectomy

et al. 2012

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Reduced port surgery (RPS), in which fewer ports are used than that in a conventional laparoscopic procedure, is becoming increasingly popular for various surgeries. However, the application of RPS to the field of gastrectomy is still underdeveloped. We started laparoscopy-assisted total gastrectomy through an umbilical port plus another 5 mm port (dual port laparoscopy-assisted total gastrectomy: DP-LATG) as an RPS for laparoscopyassisted total gastrectomy (LATG). A SILS TM port was inserted into an umbilical incision, while another 5 mm port was inserted at the right flank region. We performed DP-LATG on ten early gastric cancer cases consecutively from May 2011 onwards, with the surgeries all performed by a single surgeon. The results of DP-LATG were compared with the resuls of ten conventional LATGs (C-LATGs) that were performed between March 2010 and April 2011. There were no significant differences in the mean operation time (DP-LATG, 253.0 ± 26.8 min; C-LATG, 235.5 ± 20.6 min; p = 0.119), mean blood loss (33.4 ± 23.7, 39.8 ± 60.4 mL, p = 0.759), and number of lymph nodes dissected (31.6 ± 12.3, 40.9 ± 18.7, p = 0.205). There were no intraoperative complications, there was no need for additional ports, and there were no conversions to open surgery nor postoperative complications in the DP-LATG cases. We successfully and safely performed DP-LATG without incurring any notable differences from C-LATG in terms of operation time, blood loss, and number of lymph nodes dissected.

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“…With the advances in technology and surgical techniques, totally laparoscopic distal gastrectomy may now be performed intra-abdominally using only endoscopic linear staplers. Totally laparoscopic distal gastrectomy has been defined as a method to intracorporeally perform resection and anastomosis using a laparoscopic technique (4)(5)(6)(7). Totally laparoscopic distal gastrectomy has several advantages over laparoscopy-assisted distal gastrectomy, including reduced injury and a lower degree of invasiveness (4).…”

Section: Introductionmentioning

confidence: 99%

Totally laparoscopic D2 radical distal gastrectomy using Billroth II anastomosis: A case report

et al. 2016

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Abstract.Here, we present our first case of totally laparoscopic D2 radical distal gastrectomy using Billroth II anastomosis and evaluate its effectiveness in terms of minimal invasiveness, technical feasibility and safety for the resection of early gastric cancer. In the present case, only laparoscopic linear staplers were used for intracorporeal anastomosis. The time taken was 180 min, the anastomotic time was 15 min, the number of staples used was five, and the estimated blood loss was 30 ml. The first flatus was observed at 3 days, and a liquid diet was started at 6 days. The postoperative hospital stay was 8 days. No postoperative complications were noted with our case. In conclusion, totally laparoscopic Billroth II anastomosis using laparoscopic linear staplers for early gastric cancer is considered to be safe and feasible. IntroductionAs a minimally invasive surgical technique, laparoscopic radical gastrectomy is associated with advantages including reduced injury and postoperative pain, lower impact on immune function, milder morbidity and rapid recovery of gastrointestinal function with a short hospital stay (1-3). Laparoscopic gastrectomy is commonly performed in Taizhou Hospital, China, for the treatment of early and advanced gastric cancer. With the advances in technology and surgical techniques, totally laparoscopic distal gastrectomy may now be performed intra-abdominally using only endoscopic linear staplers. Totally laparoscopic distal gastrectomy has been defined as a method to intracorporeally perform resection and anastomosis using a laparoscopic technique (4-7). Totally laparoscopic distal gastrectomy has several advantages over laparoscopy-assisted distal gastrectomy, including reduced injury and a lower degree of invasiveness (4).Here, we present our initial experience with the first patient who underwent totally laparoscopic D2 radical distal gastrectomy using Billroth II anastomosis in our institution. We evaluated the effectiveness of totally laparoscopic D2 radical distal gastrectomy using Billroth II anastomosis in terms of minimal invasiveness, technical feasibility and safety for the resection of early gastric cancer. Case reportPatient. A 55-year-old male patient was admitted to our hospital due to upper abdominal discomfort accompanied with belching for three years. Gastroscopic biopsy confirmed the presence of adenocarcinoma of the gastric antrum (well differentiated). Abdominal computed tomography (CT) scan revealed the location of the gastric tumor (Fig. 1). No evidence of distant metastasis was observed during the preoperative abdominal CT scan. The preoperative tumor-node-metastasis (TNM) stage was cT2N0M0.Surgical procedure. Following the administration of general anesthesia, the patient was placed in the supine position with the head elevated and legs apart. During the surgery, five trocars were inserted. CO 2 pneumoperitoneum of 12 to 14 mmHg was established. Standing on the left side of the patient, the surgeon divided the stomach and duodenum using an ultrasonic scalpel ...

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Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer: early and long-term results of a 100-patient series

Cited by 97 publications

References 29 publications

Long‐term outcomes after laparoscopy‐assisted gastrectomy for advanced gastric cancer: Analysis of consecutive 106 experiences

Long‐term outcomes after laparoscopy‐assisted gastrectomy for advanced gastric cancer: Analysis of consecutive 106 experiences

The initial experience of dual port laparoscopy-assisted total gastrectomy as a reduced port surgery for total gastrectomy

Totally laparoscopic D2 radical distal gastrectomy using Billroth II anastomosis: A case report

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