Comparison of Laparoscopic Versus Open Gastrectomy for Treatment of Gastric Cancer: Analysis of a Textbook Outcome

Priego, Pablo; Cuadrado, Marta; Ballestero, Araceli; Galindo, Julio; Lobo, Eduardo

doi:10.1089/lap.2018.0489

Cited by 32 publications

(24 citation statements)

References 25 publications

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“…The rate of conversion to open surgery can vary geographically, just like morbidity and mortality rates. While the rate of conversion to open surgery has been reported to be between 6.4% to 6.6% in Asian studies (7,15), this rate has been reported as 18% in a European study (9). In our study, the conversion rate to open surgery was 10%.…”

Section: Discussioncontrasting

confidence: 56%

“…The absence of tactile sensation in laparoscopic surgery may cause difficulties in determining tumor localization and surgical margins. Tumor positive surgical margin rate in minimally invasive gastrectomy has been reported to be 6.9-7.5% (9,10). In our study, tumor localization and surgical margins were determined by performing routine intraoperative gastroscopy in the laparoscopic group.…”

Section: Discussionmentioning

confidence: 91%

“…The majority of these studies are from Asian countries where tumor incidence is high, the tumor is diagnosed at an early stage and a young age with screening programs and cancer surgery is performed in specialized centers (6)(7)(8). The experience of laparoscopic gastrectomy is limited in European countries where tumor epidemiology and patient characteristics are different (9,10).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of open and laparoscopic gastrectomy for gastric cancer: a low volume center experience

et al. 2021

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Objective: In gastric cancer, laparoscopic gastrectomy is commonly performed in Asian countries. In other regions where tumor incidence is relatively low and patient characteristics are different, developments in this issue have been limited. In this study, we aimed to compare the early results for patients who underwent open or laparoscopic gastrectomy for gastric cancer in a low volume center. Material and Methods: We retrospectively analyzed the data of patients who underwent curative gastric resection (open gastrectomy n: 30; laparoscopic gastrectomy n: 30) by the same surgical team between 2014 and 2019. Results: The tumor was localized in 60% (36/60) of the patients in the proximal and middle 1/3 stomach. In laparoscopic gastrectomy group, the operation time was significantly longer (median, 297.5 vs 180 minutes; p< 0.05). In open gastrectomy group, intraoperative blood loss (median 50 vs 150 ml; p< 0.05) was significantly higher. Tumor negative surgical margin was achieved in all cases. Although the mean number of lymph nodes harvested in laparoscopic gastrectomy group was higher than the open surgery group, the difference was not statistically significant (28.2 ± 11.48 vs 25.8 ± 9.78, respectively; p= 0.394). The rate of major complications (Clavien-Dindo ≥ grade 3) was less common in the laparoscopic group (6.7% vs 16.7%; p= 0.642). Mortality was observed in four patients (2 patients open, 2 patients laparoscopic). Conclusion: In low-volume centers with advanced laparoscopic surgery experience, laparoscopic gastrectomy for gastric cancer can be performed with the risk of morbidity-mortality similar to open gastrectomy.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Comparison of open and laparoscopic gastrectomy for gastric cancer: a low volume center experience

et al. 2021

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“…More recently, composite measures have been proposed as a better means to assess variation among hospital performance rather than individual parameters 9,27 . To this point, our group and others have proposed TO as an “all or none” measure that more accurately represent a patient‐centered care perspective 28–32 . The current study was important because we examined USNWR rankings relative to success in achieving TO among patients undergoing colorectal, lung, esophagus, liver, and pancreatic surgery for cancer at honor roll and nonhonor roll hospitals.…”

Section: Discussionmentioning

confidence: 99%

Comparing textbook outcomes among patients undergoing surgery for cancer at U. S. News & World Report ranked hospitals

Mehta

Tsilimigras

Paredes

et al. 2020

Journal of Surgical Oncology

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Background The objective of the current study was to define and compare rates of textbook outcomes (TO) among patients undergoing colorectal, lung, esophagus, liver, and pancreatic surgery for cancer at U.S. News & World Report (USNWR) ranked hospitals. Methods Medicare Inpatient Standard Analytic Files 2013‐2015 were utilized to examine the relationship of TO and USNWR hospital ratings following surgery for colorectal, lung, esophageal, pancreatic, and liver cancer. TO was defined as no postoperative surgical complications, no prolonged length of hospital stay, no readmission within 90 days after discharge, and no postoperative mortality within 90 days after surgery. Results Among the 35,352 Medicare patients included in the cohort, 16,820 (47.6%) underwent surgery at honor roll hospitals, whereas 18 532 (52.4%) underwent surgery at non‐honor roll hospitals. The overall proportion of patients who achieved TO was 50.1%. In examining the clinical outcomes of patients who underwent surgery, there was no difference in the odds of achieving TO at honor roll vs non‐honor roll hospitals (colorectal: odds ratio [OR], 0.87; 95% confidence interval [CI], 0.69‐1.10; lung: OR, 1.07; 95% CI, 0.87‐1.32; esophagus: OR, 1.44; 95% CI, 0.72‐2.89; liver: OR, 1.27; 95% CI, 0.87‐1.84; pancreas: OR, 1.04; 95% CI, 0.67‐1.62). Conclusion and Relevance Patients undergoing surgery for lung, esophageal, liver, pancreatic, and colorectal cancer had comparable rates of TO at honor roll vs non‐honor roll hospitals. No linear association was observed between hospital position in the rank and postoperative outcomes such as TO indicating that patients should not overly focus on the exact position within USNWR ranked hospitals. These data highlight to patients and physicians that up to one‐half of patients undergoing surgery for cancer should anticipate at least one adverse outcome.

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“…The theoretical advantage of the TO concept is that it may provide an estimation of quality of care by surgeons and patients, and it can allow the classification of hospitals and institutions as experts based on their performance. To date, TOs have been developed for several gastrointestinal malignancies—including esophagogastric and hepatobiliary malignancies 18,21‐25 . These same metrics have not been established for STS‐E.…”

Section: Introductionmentioning

confidence: 99%

Defining a textbook surgical outcome for patients undergoing surgical resection of intermediate and high‐grade soft tissue sarcomas of the extremities

Lazarides

Cerullo

Moris

et al. 2020

Journal of Surgical Oncology

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Background Quality measures for the surgical management soft tissue sarcoma of the extremity are limited. The purpose of this study was to define a textbook surgical outcome (TO) for soft tissue sarcoma of the extremities (STS‐E) and to examine its associations with hospital volume and overall survival. Methods All patients in the National Cancer Database undergoing resection of primary STS‐E between 2004 and 2015 were identified. The primary outcome was a TO, defined as: hospital length of stay (LOS) <75th percentile, survival >90 days from the date of surgery, no readmission within 30 days of discharge, and negative surgical margins (R0 resection). Results Overall, 7658 patients met criteria for inclusion; a TO was achieved in 4291 (56%) patients. Of patients who did not achieve TOs, 51.9% (n = 1748) had an extended LOS, and 47.3% (n = 1591) did not have negative margins. Older age, more medical comorbidities, and non‐white or black race were independently associated with not receiving a TO (P = .034). With respect to tumor and treatment characteristics, larger tumor size, lower extremity location and higher grade were independently associated with not receiving a TO (P < .001). Hospital volume was not associated with a TO. TOs conferred a significant survival benefit (hazrds ratio = 0.71 [0.65‐0.78], P < .001). A TO was associated with a 27.5% longer survival time (P < .001). Conclusions This study defined a TO in intermediate and high‐grade STS‐E and demonstrated that this outcome measure is associated with overall survival. Facility volume was not associated with a TO.

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Comparison of Laparoscopic Versus Open Gastrectomy for Treatment of Gastric Cancer: Analysis of a Textbook Outcome

Cited by 32 publications

References 25 publications

Comparison of open and laparoscopic gastrectomy for gastric cancer: a low volume center experience

Comparison of open and laparoscopic gastrectomy for gastric cancer: a low volume center experience

Comparing textbook outcomes among patients undergoing surgery for cancer at U. S. News & World Report ranked hospitals

Defining a textbook surgical outcome for patients undergoing surgical resection of intermediate and high‐grade soft tissue sarcomas of the extremities

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