Gastrectomía totalmente laparoscópica por neoplasias gástricas: Experiencia en un centro público

Norero, Enrique; Báez, Sergio; Briceño, Eduardo; Martinez, Carlos R.; Ceroni, Marco; Escalona, Alex; Aguayo, Gloria; González, Paulina; Araos, Fernando; Calvo, Alfonso; Díaz, Alejandro; Viñuela, Eduardo

doi:10.4067/s0034-98872015000300001

Cited by 6 publications

(8 citation statements)

References 33 publications

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“…Most publications describing LG originate in Asia 14 , 15 . In the West, LG has not been widely adopted and has been developed consistently by only a few expert centres 7 , 13 , 20 , 23 , 30 . In fact, the applicability of LG has been questioned by our Asian colleagues 9 , but our study supports the applicability of LG in countries outside Asia.…”

Section: Discussionsupporting

confidence: 48%

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Survival and Perioperative Morbidity of Totally Laparoscopic Versus Open Gastrectomy for Early Gastric Cancer: Analysis From a Single Latin American Centre

Norero¹,

Vargas²,

Achurra³

et al. 2019

ABCD, arq. bras. cir. dig.

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Background:Laparoscopic gastrectomy has numerous perioperative advantages, but the long-term survival of patients after this procedure has been less studied. Aim:To compare survival, oncologic and perioperative outcomes between completely laparoscopic vs. open gastrectomy for early gastric cancer. Methods:This study was retrospective, and our main outcomes were the overall and disease-specific 5-year survival, lymph node count and R0 resection rate. Our secondary outcome was postoperative morbidity. Results:Were included 116 patients (59% men, age 68 years, comorbidities 73%, BMI 25) who underwent 50 laparoscopic gastrectomies and 66 open gastrectomies. The demographic characteristics, tumour location, type of surgery, extent of lymph node dissection and stage did not significantly differ between groups. The overall complication rate was similar in both groups (40% vs. 28%, p=ns), and complications graded at least Clavien 2 (36% vs. 18%, p=0.03), respiratory (9% vs. 0%, p=0.03) and wound-abdominal wall complications (12% vs. 0%, p=0.009) were significantly lower after laparoscopic gastrectomy. The lymph node count (21 vs. 23 nodes; p=ns) and R0 resection rate (100% vs. 96%; p=ns) did not significantly differ between groups. The 5-year overall survival (84% vs. 87%, p=0.31) and disease-specific survival (93% vs. 98%, p=0.20) did not significantly differ between the laparoscopic and open gastrectomy groups. Conclusion:The results of this study support similar oncologic outcome and long-term survival for patients with early gastric cancer after laparoscopic gastrectomy and open gastrectomy. In addition, the laparoscopic approach is associated with less severe morbidity and a lower occurrence of respiratory and wound-abdominal wall complications.

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Section: Discussionsupporting

confidence: 48%

“…Since the first laparoscopic gastrectomy (LG) was performed in 1994 by Kitano 17 , the application of minimally invasive surgery to treat gastric cancer has exponentially increased 3 , 29 . Most publications originate from Asian countries 15 , and reports seldom originate from South America 23 , 30 .…”

Section: Introductionmentioning

confidence: 99%

Survival and Perioperative Morbidity of Totally Laparoscopic Versus Open Gastrectomy for Early Gastric Cancer: Analysis From a Single Latin American Centre

Norero¹,

Vargas²,

Achurra³

et al. 2019

ABCD, arq. bras. cir. dig.

Self Cite

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“…At our 2 hospitals, the use of a single-layer hand-sewn EJ showed leak rates of 6% and 8%, respectively [ 3 4 ]. The results obtained with the 2-layer hand-sewn EJ described in this paper are better than our historical data, as this method reduced EJ leak rates to 3%, and EJ stenosis to 1%.…”

Section: Discussionmentioning

confidence: 99%

“…Our TLTG technique has been previously described [ 3 4 ]. A pneumoperitoneum with CO 2 at 15 mmHg is established.…”

Section: Methodsmentioning

confidence: 99%

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Two-Layer Hand-Sewn Esophagojejunostomy in Totally Laparoscopic Total Gastrectomy for Gastric Cancer

et al. 2017

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PurposeDifferent esophagojejunostomy (EJ) reconstruction methods are used after totally laparoscopic total gastrectomy (TLTG), and none is considered a standard technique. This report describes a 2-layer hand-sewn EJ technique during TLTG; we also evaluated postoperative morbidity associated with this technique.Materials and MethodsThis retrospective cohort study included all consecutive patients who underwent TLTG for gastric cancer (GC) from 2012 to 2016 at 2 affiliated teaching hospitals. All participating surgeons performed standardized intracorporeal 2-layer hand-sewn EJ.ResultsWe included 51 patients who underwent TLTG for GC and standardized EJ anastomosis. Twenty-seven (53%) were male, and the median age was 60 (36–87) years. The average operative time was 337±71 minutes and intraoperative bleeding was 160±107 mL. There were no open conversions related to EJ. Postoperative morbidity was observed in 9 (17.0%) patients. There was no postoperative mortality. EJ leakage was observed in 2 patients (3.8%) and 1 patient (1.9%) developed EJ stenosis. Patients with leakage were managed non-operatively and the patient with stenosis required endoscopic dilation. The median length of hospital stay was 8 (6–29) days.ConclusionsTwo-layer hand-sewn EJ during TLTG for GC is a feasible and safe technique. This method avoids a laparotomy for reconstruction and the disadvantages associated with laparoscopic introduction of mechanical staplers for EJ, and provides an alternative for alimentary tract reconstruction after TLTG.

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Improvement in postoperative mortality in elective gastrectomy for gastric cancer: Analysis of predictive factors in 1066 patients from a single centre

Norero

Vega

Díaz

et al. 2017

European Journal of Surgical Oncology (EJSO)

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Gastrectomía totalmente laparoscópica por neoplasias gástricas: Experiencia en un centro público

Abstract: (Rev Med Chile 2015; 143: 281-288)

Cited by 6 publications

References 33 publications

Survival and Perioperative Morbidity of Totally Laparoscopic Versus Open Gastrectomy for Early Gastric Cancer: Analysis From a Single Latin American Centre

Survival and Perioperative Morbidity of Totally Laparoscopic Versus Open Gastrectomy for Early Gastric Cancer: Analysis From a Single Latin American Centre

Two-Layer Hand-Sewn Esophagojejunostomy in Totally Laparoscopic Total Gastrectomy for Gastric Cancer

Improvement in postoperative mortality in elective gastrectomy for gastric cancer: Analysis of predictive factors in 1066 patients from a single centre

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