Completely laparoscopic versus open gastrectomy for early and advanced gastric cancer: a matched cohort study

Moisan, Fabrizio; Norero, Enrique; Slako, Milenko; Varas, Julián; Palominos, Gonzalo; Crovari, Fernando; Ibáñez, Luis; Pérez, Gustavo; Pimentel, Fernando; Guzmán, Sergio; Jarufe, Nicolás; Boza, Camilo; Escalona, Alex; Funke, Ricardo

doi:10.1007/s00464-011-1933-5

Cited by 66 publications

(56 citation statements)

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“…Francescutti and colleagues 27 have reported the only previous Canadian experience, but they included patients with benign lesions as well as those with malignant ones. All comparative studies have reported decreased or similar early postoperative morbidity with LAG ranging from 0% to 26%, [15][16][17][26][27][28][29]31 which compares with our results. Other benefits of the laparoscopic ap proach, including decreased time to ambulation and resumed diet, decreased consumption of analgesia and a shorter length of stay, have been reported in these studies.…”

Section: Discussionsupporting

confidence: 88%

“…Others reported no difference between the laparoscopic and open approaches. 15,16,[26][27][28][29][30][31]33 In a meta-analysis of RCTs comparing laparoscopic and open approaches for early gastric cancer, Ohtani and colleagues 9 concluded that there was a lesser number of LNs with laparoscopy. Debate is still ongoing about the extent of the lymphadenectomy and the number of LNs needed in the specimen.…”

Section: Discussionmentioning

confidence: 99%

“…No margins were positive for patients treated with a curative intent, so no difference was observed between groups, which is consistent with the current Western literature. 15,16,[26][27][28][29][30][31]33 However, obtaining a safe distal margin laparoscopically can be challenging for lesions seating close to the pylorus. This was the reason for 1 of the conversions in the LAG group in our study.…”

Section: Discussionmentioning

confidence: 99%

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Oncologic specimen from laparoscopic assisted gastrectomy for gastric adenocarcinoma is comparable to D1-open surgery: the experience of a Canadian centre

Hallet

Labidi²,

Bouchard‐Fortier³

et al. 2013

cjs

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Background:The Eastern experience has reported the safety of laparoscopic assisted gastrectomy (LAG) for gastric cancer. Its use in Western countries is still debated owing to concerns about its oncologic equivalence to open gastrectomy (OG). We sought to review and compare their operative outcomes and oncologic specimen quality (number of harvested lymph nodes and surgical margins) for gastric adenocarcinoma (GA). Methods:We reviewed the charts of all patients undergoing LAG (2007( ) and OG (2000 for GA in a single institution. Several surgeons performed the OGs, whereas 1 fellowship-trained laparoscopic surgeon performed LAGs. The primary outcome was quality of the surgical specimen, assessed by the number of harvested lymph nodes (LNs) and margin status. Secondary outcomes were perioperative events. Data were analyzed as intention to treat. Results:We retrieved 60 cases (47 OGs, 13 LAGs). The conversion rate was 23%. Conclusion:Laparoscopic assisted gastrectomy is a challenging but safe and feasible procedure in experienced hands. It offers the same radical resection as OG regarding negative margins and LN retrieval. Long-term follow-up is warranted.Contexte : La gastrectomie assistée par laparoscopie (GAL) a été démontrée dans des études orientales comme sécuritaire dans le traitement de l'adénocarcinome gastrique (AG). En occident, l'équivalence oncologique de la GAL avec la gastrectomie ouverte (GO) demeure cependant controversée. Cette étude vise à comparer le devenir postopératoire et la qualité des spécimens oncologiques de ces interventions, dans le traitement de l'AG. (2007)(2008)(2009)(2010) ou GO (2000GO ( -2010 pour AG dans un seul centre hospitalier ont été revus. Différents chirurgiens ont réalisé les GO. Toutes les GAL ont été réalisées par un seul chirurgien sur-spécialisé en chirurgie laparoscopique. Le critère d'évaluation principal était la qualité du spécimen chirurgical évaluée par le nombre de ganglions lymphatiques (GL) prélevés et le statut des marges de résection. Le critère d'évaluation secondaire était la morbidité postopératoire. Les données ont été analysées en fonction de l'intention de traiter. Méthodes : Tous les dossiers de patients opérés par GALRésultats : Soixante cas ont été inclus (47 GO, 13 GAL). Le taux de conversion s'est établi à 23 %. Le temps opératoire moyen était plus long de 115 minutes, et les pertes sanguines moyennes moindres de 425 mL (p < 0,001 dans les 2 cas) pour la GAL que pour la GO. Une moyenne de 14,4 (écart-type [ET] 9,8) et 11,2 (ET 8,2) GL ont été prélevés respectivement pour la GO et la GAL (p = 0.29). On a obtenu des marges négatives pour tous les patients. La durée moyenne du séjour ne différait pas (GAL 19 j c. GO 18,9 j; p = 0,91). Les complications majeures (12,7 % c. 23,1 %; p = 0,39) et la mortalité post-opératoires (2,1 % c. 7,7 %; p = 0,32) étaient similaires. Conclusion :La gastrectomie assistée par laparoscopie est une intervention complexe, mais peut être réalisée de manière sécuritaire en des mains expertes. Elle offre un spécimen onc...

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Oncologic specimen from laparoscopic assisted gastrectomy for gastric adenocarcinoma is comparable to D1-open surgery: the experience of a Canadian centre

Hallet

Labidi²,

Bouchard‐Fortier³

et al. 2013

cjs

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“…Los pacientes con carcinoide tipo III tienen mayores posibilidades de recidiva dependiendo de su etapificación y variables histopatológicas como las ya comentadas, siendo en este grupo en donde debemos tener mayor cautela. Nuestra experiencia inicial en cáncer gástrico y gastrectomía laparoscópica presenta buenos resultados a 3 años de seguimiento al comparar con cirugía abierta 22 , sin embargo, en esta patología aún debemos juntar un mayor número de casos y con seguimiento a más largo plazo antes de afirmar su real ventaja.…”

Section: Discussionunclassified

Gastrectomía laparoscópica en carcinoide gástrico

et al. 2013

Rev Chil Cir

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Laparoscopic gastrectomy in gastric carcinoidIntroduction: Gastric carcinoid is a very low frequency tumor. A proportion of them require surgery to control the disease. The ideal surgical treatment is controversial. Aim: To describe the perioperative and follow-up course of patients with gastric carcinoid subjected to laparoscopic gastrectomy. Materials and Methods: Retrospective study of patients undergoing some type of laparoscopic gastrectomy for gastric carcinoid the last 10 years. We collected demographic background, preoperative evaluation, type of surgery, complications and follow-up. Results: During the study period were operated 7 patients, 5 were men. The average age was 54 years. In three patients the diagnosis was a finding, while the rest had abdominal pain associated with nonspecific symptoms. Four patients had a type I gastric carcinoid associated with chronic gastritis and hypergastrinemia, and the others had a type III gastric carcinoid. Six patients underwent laparoscopic total gastrectomy while in the remaining patient (type III) was subtotal. There were no postoperative complications. During follow-up one patient required a reoperation for mechanical ileus secondary to adhesions and one patient required endoscopic dilatation because esophagoyeyunostomy stenosis. At 32 months of median follow-up (1-52) no patient has relapsed. Conclusion: Laparoscopic gastrectomy is an alternative in the surgical treatment of patients with gastric carcinoid. It´s safe and represent adequate oncological results in the short and medium term.

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“…First, MIS techniques are being used in more radical but less invasive procedures, such as totally laparoscopic distal gastrectomy or laparoscopic total gastrectomy with D1+ or D2 lymphadenectomy. These procedures are comparable to conventional open surgery and can be performed even in patients with advanced gastric cancer (AGC) [21][22][23] . Second, MIS is being employed for function-preserving surgery, including pylorus-preserving gastrectomy (PPG), proximal gastrectomy, and limited gastrectomy with sentinel node navigation surgery.…”

Section: Abstract: Gastric Cancer; Minimally Invasive Surgery; Laparmentioning

confidence: 99%

Minimally Invasive Surgery of Gastric Cancer

Güner

Hyung

2017

Minimally Invasive Surgery for Upper Abdominal Cancer

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Minimally invasive surgery for gastric cancer has rapidly gained popularity due to the early detection of early gastric cancer. As advances in instruments and the accumulation of laparoscopic experience increase, laparoscopic techniques are being used for less invasive but highly technical procedures. Recent evidence suggests that the short-and long-term outcomes of minimally invasive surgery for early gastric cancer and advanced gastric cancer are comparable to those of conventional open surgery. However, these results should be confirmed by large-scale multicenter prospective randomized controlled clinical trials.© 2014 Baishideng Publishing Group Inc. All rights reserved. Key words: Gastric cancer; Minimally invasive surgery; Laparoscopic gastrectomyCore tip: Minimally invasive surgery has become an alternative modality for the treatment of gastric cancer.Son SY, Kim HH. Minimally invasive surgery in gastric cancer. World J Gastroenterol 2014; 20(39): 14132-14141 Available from: URL: http://www.wjgnet.com/1007-9327/full/ v20/i39/14132.htm DOI: http://dx.doi.org/10.3748/wjg.v20. tano et al [9] and Nagai et al [10] reported the success of laparoscopy-assisted distal gastrectomy (LADG) for EGC in 1994 and 1995. In the early 2000s, robot-assisted surgery emerged as one of the treatment modalities for EGC, and the first robot-assisted gastrectomy (RAG) for EGC was reported by Hashizume et al [11] in 2003. In 2011, singleincision laparoscopic surgery was described for EGC [12] . MIS has revolutionized the surgical approach to gastric cancer for the past two decades, leading to improvements in patients' quality of life by producing less pain, less blood loss, earlier postoperative recovery, and a shorter hospital stay [13][14][15][16][17][18][19] .Currently, MIS is evolving in two major directions [20] . First, MIS techniques are being used in more radical but less invasive procedures, such as totally laparoscopic distal gastrectomy or laparoscopic total gastrectomy with D1+ or D2 lymphadenectomy. These procedures are comparable to conventional open surgery and can be performed even in patients with advanced gastric cancer (AGC) [21][22][23] . Second, MIS is being employed for function-preserving surgery, including pylorus-preserving gastrectomy (PPG), proximal gastrectomy, and limited gastrectomy with sentinel node navigation surgery. These procedures can assist in improving patients' late postoperative function and quality of life [20,[24][25][26] . RECENT ADVANCES IN LAPAROSCOPIC GASTRECTOMYAs advances in instruments and the accumulation of laparoscopic experience increase, laparoscopic techniques are being used for less invasive but highly technical procedures. Totally laparoscopic gastrectomy (TLG) is one example. TLG has gained popularity since Kanaya et al [27] reported the first delta-shaped anastomosis. A recent meta-analysis (five studies, 652 patients) showed that totally laparoscopic distal gastrectomy has less bleeding, shorter time to first flatus, and lower rates of postoperative complicat...

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Completely laparoscopic versus open gastrectomy for early and advanced gastric cancer: a matched cohort study

Abstract: In this preliminary report, with 52% of advanced tumor, the 3-year overall and stage-by-stage survival was comparable for laparoscopic and open curative gastrectomy.

Cited by 66 publications

References 48 publications

Oncologic specimen from laparoscopic assisted gastrectomy for gastric adenocarcinoma is comparable to D1-open surgery: the experience of a Canadian centre

Oncologic specimen from laparoscopic assisted gastrectomy for gastric adenocarcinoma is comparable to D1-open surgery: the experience of a Canadian centre

Gastrectomía laparoscópica en carcinoide gástrico

Minimally Invasive Surgery of Gastric Cancer

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