Inspection of Safety and Accuracy of D2 Lymph Node Dissection in Laparoscopy‐Assisted Distal Gastrectomy

Kawamura, Hideki; Homma, Shigenori; Yokota, Ryoichi; Yokota, Kentaro; Watarai, Hiroshi; Hagiwara, Masatoshi; Sato, Masanori; Noguchi, K.; Ueki, Shinya; Kondo, Yukifumi

doi:10.1007/s00268-008-9697-3

Cited by 59 publications

(44 citation statements)

References 24 publications

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“…After reading the full texts of the remaining papers, 24 studies were removed as they only reported the outcomes of LG for AGC whereas no controlled or matched cases treated by OG were available. Among the remaining articles, 19 studies [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55] were excluded because EGC cases were mixed with AGCs in the cohort studies and data on AGCs were not extractable. Eight studies were further deleted for the following reasons: 2 studies were ongoing randomized controlled trials (RCTs) that only described study design and patient enrollment criteria without results reported [56,57]; 2 studies had overlapped enrollments with former research [58,59]; 1 study reported incomplete data that were not suitable for analysis [60]; and 3 studies discussed other issues irrelevant to the topic of this meta-analysis [61][62][63].…”

Section: Resultsmentioning

confidence: 99%

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

Quan

Huang

et al. 2015

Gastric Cancer

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Background Laparoscopic gastrectomy (LG) has been used as an alternative to open gastrectomy (OG) to treat early gastric cancer. However, the use of LG for advanced gastric cancer (AGC) has been in debate. Methods Literature retrieval was performed by searching PubMed, EMBASE, and the Cochrane library up to July 2014. Potential studies comparing the surgical effects between LG with OG were evaluated and data were extracted accordingly. Meta-analysis was carried out using RevMan. The pooled risk ratio and weighted mean difference (WMD) with 95 % confidence interval (95 % CI) were calculated. Results Overall, 26 studies were included in this metaanalysis. LG had some advantages over OG, including shorter hospitalization (WMD, -3.63, 95 % CI, -4.66 to -2.60; P \ 0.01), less blood loss (WMD, -161.37, 95 % CI, -192.55 to -130.18; P \ 0.01), faster bowel recovery (WMD, -0.78, 95 % CI, -1.05 to -0.50; P \ 0.01), and earlier ambulation (WMD, -0.95, 95 % CI, -1.47 to -0.44; P \ 0.01). In terms of surgical and oncological safety, LG could achieve similar lymph nodes (WMD, -0.49, 95 % CI, -1.78 to 0.81; P = 0.46), a lower complication rate [odds ratio (OR), 0.71, 95 % CI, 0.59 to 0.87; P \ 0.01], and overall survival (OS) and disease-free survival (DFS) comparable to OG. Conclusions For AGCs, LG appeared comparable with OG in short-and long-term results. Although more time was needed to perform LG, it had some advantages over OG in achieving faster postoperative recovery. Ongoing trials and future studies could help to clarify this controversial issue.

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Section: Resultsmentioning

confidence: 99%

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

Quan

Huang

et al. 2015

Gastric Cancer

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“…If the feasibility and safety of LGS in the treatment of EGC has been proven, it is also true that several reports have shown the efficacy of LGS in the cure of EGC with results comparable to those of an OGS series [11,12] .…”

Section: Lgs (N = 22) Ogs (N = 25) P Valuementioning

confidence: 99%

Comparative study of laparoscopicvsopen gastrectomy in gastric cancer management

Sica¹

2011

WJG

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17|Issue 41| WJG|www.wjgnet.com related and overall survival probability by Kaplan-Meier method showed comparable results (P = 0.81 and P = 0.83, respectively). We found no differences in surgical complications in the 2 groups. There was no conversion to open surgery in this series. CONCLUSION:LGS is as effective as OGS in the management of advanced gastric cancer. However LGS cannot be recommended routinely over OGS for the treatment of advanced gastric cancer.

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“…Furthermore, the timing and patterns of recurrence after laparoscopy-assisted gastrectomy are unknown, although there has been concern regarding the possibility of recurrence related specifically to laparoscopic surgery, such as port-site metastasis or peritoneal metastasis, and concern about inadequate lymph node dissection during laparoscopy-assisted gastrectomy due to its technical difficulty and dependency on surgeon proficiency. [8][9][10][11][12][13][14] The purpose of this retrospective multicenter study is to assess recurrence and its timing, patterns, and risk factors following laparoscopy-assisted gastrectomy as well as survival for gastric cancer based on large-scale data.…”

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confidence: 99%

Recurrence Following Laparoscopy-Assisted Gastrectomy for Gastric Cancer: A Multicenter Retrospective Analysis of 1,417 Patients

et al. 2010

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Background. The risk of recurrence and recurrence patterns after laparoscopy-assisted gastrectomy for gastric cancer remain unclear. The objective of this study is to assess recurrence and its timing, patterns, and risk factors following laparoscopy-assisted gastrectomy from multicenter data. Methods. A retrospective multicenter study was performed using data from 1,485 patients who had undergone laparoscopy-assisted gastrectomy for gastric cancer at ten institutions from 1998 to 2005. Recurrence and its timing and patterns were reviewed. Univariate and multivariate analyses were performed to identify risk factors for recurrence. Results. Excluding 68 patients (9 postoperative mortalities, 1 synchronous distant metastasis, 2 nonadenocarcinomas, and 56 losses to follow-up), 50 of 1,417 patients (3.5%) had recurrences. Incidence of recurrence was 1.6% (19/1186) in early gastric cancer and 13.4% (31/231) in advanced gastric cancer. Recurrence occurred in 34 of 50 patients (68.0%) within 2 years of surgery, and in 45 of 50 patients (90.0%) within 3 years. The recurrence pattern was hematogenous in 17 patients (34.0%), peritoneal in 11 (22.0%), locoregional in 10 (20.0%), distant lymph nodes in 2 (4.0%), and mixed in 10 (20.0%). Advanced T-classification and lymph node metastases were risk factors for recurrence. Conclusions. Laparoscopy-assisted gastrectomy showed satisfactory long-term oncologic outcomes similar to those of open surgery. The study provides additional evidence suggesting that laparoscopy-assisted gastrectomy is a good alternative to open gastrectomy in patients with gastric cancer of relatively early stage, although results of a randomized controlled trial and more long-term follow-up are needed to provide conclusive evidence.

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Inspection of Safety and Accuracy of D2 Lymph Node Dissection in Laparoscopy‐Assisted Distal Gastrectomy

Abstract: D2 dissection in LADG can be performed without problems with safety and accuracy, if the surgical team is skilled in the procedures of LADG.

Cited by 59 publications

References 24 publications

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

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

Comparative study of laparoscopicvsopen gastrectomy in gastric cancer management

Recurrence Following Laparoscopy-Assisted Gastrectomy for Gastric Cancer: A Multicenter Retrospective Analysis of 1,417 Patients

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