Laparoscopy-assisted Distal Gastrectomy for Gastric Cancer

Overview

Journal J Gastrointest Surg

Specialty Gastroenterology

Date 2008 Aug 7

PMID 18683012

Citations 5

Authors

Teruo Kiyama

Itsuo Fujita

Hitoshi Kanno

Aya Tani

Toshiro Yoshiyuki

Shunji Kato

Takashi Tajiri

Adrian Barbul

Affiliations

Soon will be listed here.

Abstract

Objective: The purpose of this study was to evaluate the safety and value of laparoscopy-assisted distal gastrectomy (LADG) for early stage gastric cancer (stages IA, IB, and II).

Materials And Methods: We retrospectively assessed 101 cases treated by LADG and compared to 49 contemporaneous cases treated by open distal gastrectomy (DG) between 2001 and 2006. Clinical variables, such as tumor diameter, operation time, blood loss, number of lymph nodes dissected, and length of stay were investigated.

Results: Tumor size (mm) was significantly smaller in the LADG group (p < 0.0001). Although operation time (min) in the two groups was similar (278 +/- 57 vs. 268 +/- 55), mean blood loss was significantly higher in the DG group (139 +/- 181 vs. 460 +/- 301, p < 0.0001). Fewer lymph nodes were harvested in the LADG group (27 +/- 14 vs. 34 +/- 19, p = 0.012). Hospital stay was longer in the DG group (13.3 +/- 8.5 vs. 16.7 +/- 10.5, p = 0.034). There was no mortality in either group. Postoperative surgical complications occurred in six (6%) of the LADG and four (8%) of the DG.

Conclusions: The authors conclude that laparoscopy-assisted distal gastrectomy is a safe and useful operation for early-stage gastric cancers. If patients are selected properly, laparoscopy-assisted distal gastrectomy can be a curative and minimally invasive treatment for gastric cancer.

Citing Articles

Advances in the surgical management of gastric and gastroesophageal junction cancer.

Narayan R, Poultsides G Transl Gastroenterol Hepatol. 2021; 6:16.

PMID: 33409410 PMC: 7724174. DOI: 10.21037/tgh.2020.02.06.

Minimally Invasive Gastric Surgery.

Herrera-Almario G, Strong V Adv Surg. 2017; 51(1):151-164.

PMID: 28797337 PMC: 5649629. DOI: 10.1016/j.yasu.2017.03.012.

Comparison of laparoscopic versus open gastrectomy for advanced gastric cancer: an updated meta-analysis.

Quan Y, Huang A, Ye M, Xu M, Zhuang B, Zhang P Gastric Cancer. 2015; 19(3):939-50.

PMID: 26216579 DOI: 10.1007/s10120-015-0516-x.

Systemic and peritoneal inflammatory response after laparoscopic-assisted gastrectomy and the effect of inflammatory cytokines on adhesion of gastric cancer cells to peritoneal mesothelial cells.

Yu G, Tang B, Yu P, Peng Z, Qian F, Sun G Surg Endosc. 2010; 24(11):2860-70.

PMID: 20419322 DOI: 10.1007/s00464-010-1067-1.

Subtotal gastrectomy with D2 dissection by minimally invasive surgery for distal adenocarcinoma of the stomach: results and 5-year survival.

Pugliese R, Maggioni D, Sansonna F, Costanzi A, Ferrari G, Di Lernia S Surg Endosc. 2010; 24(10):2594-602.

PMID: 20414682 DOI: 10.1007/s00464-010-1014-1.

References

Kitano S, Shiraishi N . Current status of laparoscopic gastrectomy for cancer in Japan. Surg Endosc. 2003; 18(2):182-5. DOI: 10.1007/s00464-003-8820-7. View

Kitano S, Shiraishi N . Minimally invasive surgery for gastric tumors. Surg Clin North Am. 2004; 85(1):151-64, xi. DOI: 10.1016/j.suc.2004.09.004. View

Onodera H, Tokunaga A, Yoshiyuki T, Kiyama T, Kato S, Matsukura N . Surgical outcome of 483 patients with early gastric cancer: prognosis, postoperative morbidity and mortality, and gastric remnant cancer. Hepatogastroenterology. 2004; 51(55):82-5. View

Kitano S, Iso Y, Moriyama M, Sugimachi K . Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994; 4(2):146-8. View

Katai H, Sano T . Early gastric cancer: concepts, diagnosis, and management. Int J Clin Oncol. 2005; 10(6):375-83. DOI: 10.1007/s10147-005-0534-5. View

Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N . A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007; 245(1):68-72. PMC: 1867926. DOI: 10.1097/01.sla.0000225364.03133.f8. View

Etoh T, Shiraishi N, Kitano S . Laparoscopic gastrectomy for cancer. Dig Dis. 2005; 23(2):113-8. DOI: 10.1159/000088592. View

Japanese Gastric Cancer Association . Japanese Classification of Gastric Carcinoma - 2nd English Edition -. Gastric Cancer. 2002; 1(1):10-24. DOI: 10.1007/s101209800016. View

Kiyama T, Mizutani T, Okuda T, Fujita I, Tokunaga A, Tajiri T . Postoperative changes in body composition after gastrectomy. J Gastrointest Surg. 2005; 9(3):313-9. DOI: 10.1016/j.gassur.2004.11.008. View

10.

Hiki N, Shimizu N, Yamaguchi H, Imamura K, Kami K, Kubota K . Manipulation of the small intestine as a cause of the increased inflammatory response after open compared with laparoscopic surgery. Br J Surg. 2006; 93(2):195-204. DOI: 10.1002/bjs.5224. View

11.

Nakajima T . Gastric cancer treatment guidelines in Japan. Gastric Cancer. 2002; 5(1):1-5. DOI: 10.1007/s101200200000. View

12.

Yokota T, Ishiyama S, Saito T, Teshima S, Shimotsuma M, Yamauchi H . Treatment strategy of limited surgery in the treatment guidelines for gastric cancer in Japan. Lancet Oncol. 2003; 4(7):423-8. DOI: 10.1016/s1470-2045(03)01140-9. View

13.

Perrone J, Ames C, Yan Y, Landman J . Evaluation of surgical performance with standard rigid and flexible-tip laparoscopes. Surg Endosc. 2005; 19(10):1325-8. DOI: 10.1007/s00464-004-8282-6. View

14.

Ryu K, Kim Y, Lee J, Nam B, Kook M, Choi I . Surgical complications and the risk factors of laparoscopy-assisted distal gastrectomy in early gastric cancer. Ann Surg Oncol. 2008; 15(6):1625-31. DOI: 10.1245/s10434-008-9845-x. View

15.

Mori Y, Arita T, Shimoda K, Yasuda K, Yoshida T, Kitano S . Effect of periodic endoscopy for gastric cancer on early detection and improvement of survival. Gastric Cancer. 2002; 4(3):132-6. DOI: 10.1007/pl00011735. View

16.

Lin K, Ota D . Laparoscopic colectomy for cancer: an oncologic feasible option. Surg Oncol. 2001; 9(3):127-34. DOI: 10.1016/s0960-7404(01)00002-0. View

17.

Kiyama T, Mizutani T, Okuda T, Fujita I, Yamashita N, Ikeda K . Laparoscopic surgery for gastric cancer: 5 years' experience. J Nippon Med Sch. 2006; 73(4):214-20. DOI: 10.1272/jnms.73.214. View