Is Totally Laparoscopic Gastrectomy Less Invasive Than Laparoscopy-assisted Gastrectomy?: Prospective, Multicenter Study

Song, Kyo Young; Park, Cho Hyun; Kang, Han Chol; Kim, Jin-Jo; Park, Seung Man; Jun, Kyong Hwa; Chin, Hyung Min; Hur, Hoon

doi:10.1007/s11605-008-0484-0

Cited by 148 publications

(141 citation statements)

References 21 publications

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“…In TLG, the whole anastomotic procedure can be clearly viewed, thereby eliminating such tension and injuries. TLG is a less invasive treatment after ESD than laparoscopy-assisted gastrectomy for EGC [17]. However, additional treatments for non-curative resection after ESD have not been established.…”

Section: Discussionmentioning

confidence: 99%

Totally laparoscopic gastrectomy for gastric cancer after endoscopic submucosal dissection: a propensity score matching analysis

Ebihara

Okushiba

Kurashima

et al. 2015

Langenbecks Arch Surg

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Results: Operative times for TLG in ESD group and non-ESD group were 228.2 ± 53.9 and 228.1 ± 52.7 min (P=0.989), and blood loss was 45.7 ± 83.0, 71.3 ± 74.5 g, respectively (P=0.161). There were no significant differences between the groups of ESD and non-ESD in postoperative recovery and postoperative complications. In totally laparoscopic distal gastrectomy (TLDG), the patients with ESD-resected specimens of more than 50 mm in diameter had significantly longer operative times (P=0.009).Conclusions: In this study, TLG is feasible procedure treatment of gastric cancer regardless of ESD. However, TLDG is more difficult in cases where the ESD-resected specimen is more than 50 mm in diameter.

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Section: Discussionmentioning

confidence: 99%

Totally laparoscopic gastrectomy for gastric cancer after endoscopic submucosal dissection: a propensity score matching analysis

Ebihara

Okushiba

Kurashima

et al. 2015

Langenbecks Arch Surg

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“…This technique, sparing minilaparotomy, reduces the risk of postoperative infectious complications, hematoma, hernia and pain. Recent results of retrospective studies demonstrate the feasibility, safety and efficiency of totally laparoscopic gastrectomy when it is performed by high-volume laparoscopic surgeons even by a relatively prolonged operating time [23,24]. To reduce this time a modification of intracorporeal-stapled anastomosis has been developed.…”

Section: Perspectivesmentioning

confidence: 99%

Laparoscopic surgery for gastric cancer: comparative-effectiveness research and future trends

Katsios

Baltogiannis

Roukos³

2010

Expert Review of Anticancer Therapy

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“…There are great advantages in totally laparoscopic gastrectomy in exposure, pulling, surgical field, and less invasive effects over laparoscopy-assisted surgery (1)(2)(3)(4)(5)(6). Hence, this method has been attracting more and more attention from laparoscopic experts.…”

Section: Introductionmentioning

confidence: 99%

Totally laparoscopic total gastrectomy for locally advanced middle-upper-third gastric cancer

Huang

Zheng

et al. 2017

J. Vis. Surg.

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Background: Totally laparoscopic total gastrectomy (TLTG) for locally advanced middle-upper-third gastric cancer is becoming increasingly popular. The difficulty of TLTG for locally advanced middle-upperthird gastric cancer is laparoscopic spleen-preserving splenic hilar lymphadenectomy and the intracorporeal digestive tract reconstruction. We summed up a set of unique experience through clinical practice to simplify operation procedures.Methods: We performed TLTG with Huang's three-step maneuver in laparoscopic spleen-preserving splenic hilar lymphadenectomy and a later-cut overlap Roux-en-Y anastomosis in the intracorporeal digestive tract reconstruction for patients with locally advanced middle-upper-third gastric cancer. The Huang's three-step maneuver divided the complicated procedure of laparoscopic spleen-preserving splenic hilar lymphadenectomy into three steps, including the dissection of the lymph nodes (LNs) in the inferior pole region of the spleen (1 st step), the region of the splenic artery trunk (2 nd step), and the superior pole region of the spleen (3 rd step). The later-cut overlap Roux-en-Y anastomosis used only endoscopic linear staplers intracorporeally and the small intestine was cut off after the esophagojejunostomy was completed, so that we could grasp the small intestine more easily and determine the direction of anastomosis more conveniently.Results: One patient experienced later anastomotic leakage and was successfully treated by conservative in 16 consecutive patients. No patient experienced any operation-related complications. At a median follow-up of 15 months, no patients had died or experienced recurrent or metastatic disease.Conclusions: TLTG with Huang's three-step maneuver in laparoscopic spleen-preserving splenic hilar lymphadenectomy and a later-cut overlap Roux-en-Y anastomosis in the intracorporeal digestive tract reconstruction for locally advanced middle-upper-third gastric cancer was technically safe and feasible, with acceptable short-term outcomes.

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Is Totally Laparoscopic Gastrectomy Less Invasive Than Laparoscopy-assisted Gastrectomy?: Prospective, Multicenter Study

Abstract: Although totally laparoscopic distal gastrectomy needs more cost, totally laparoscopic distal gastrectomy provides shorter bowel recovery time than laparoscopy-assisted distal gastrectomy.

Cited by 148 publications

References 21 publications

Totally laparoscopic gastrectomy for gastric cancer after endoscopic submucosal dissection: a propensity score matching analysis

Totally laparoscopic gastrectomy for gastric cancer after endoscopic submucosal dissection: a propensity score matching analysis

Laparoscopic surgery for gastric cancer: comparative-effectiveness research and future trends

Totally laparoscopic total gastrectomy for locally advanced middle-upper-third gastric cancer

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