Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer

Uyama, Ichiro; Sugioka, Atsushi; Fujita, Junko; Komori, Yoshiyuki; Matsui, Hideo; Hasumi, Akitake

doi:10.1007/s101200050069

Cited by 216 publications

(148 citation statements)

References 12 publications

(16 reference statements)

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“…Consequently, several surgeons abundantly experienced in laparoscopic procedures have attempted or accomplished laparoscopic D2 lymphadenectomy during LADG and few studies had reported the possibility of applying LADG with D2 lymphadenectomy for patients with AGC [9][10][11]. Since Uyama et al first reported laparoscopyassisted total gastrectomy with D2 lymphadenectomy and distal pancreaticosplenectomy for advanced upper-third gastric cancers in 1999, there have been several studies to determine the technical feasibility of D2 lymphadenectomy in patients with AGC [4,5,[10][11][12][13][14]. However, there is no study showing the availability of LAG with D2 lymphadenectomy for treating patients with AGC in terms of surgical results such as morbidity, recurrence and survival rate, and this raises doubts about its suitability.…”

Section: Discussionmentioning

confidence: 99%

Long‐term outcomes after laparoscopy‐assisted gastrectomy for advanced gastric cancer: Analysis of consecutive 106 experiences

Lee

Kim

2009

Journal of Surgical Oncology

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Background and Objectives: The purpose of this retrospective study is to suggest the possibility of laparoscopy-assisted gastrectomy (LAG) for advanced gastric cancer (AGC) through long-term outcomes. Methods: Of 283 patients with gastric cancer who underwent LAG with extraperigastric (D2) lymphadenectomy between January 2004 and February 2009, 106 were pathologically confirmed with AGC and analyzed. Results: There were 75 men and 31 women, with a mean age of 61.4 AE 11.7 years. There were 32 total gastrectomies and 74 distal gastrectomies with D2 lymphadenectomy. The mean tumor size was 4.8 AE 2.6 cm. The mean numbers of retrieved and metastatic lymph nodes were 34.3 AE 15.3 and 5.4 AE 8.7, respectively. There was no lymph node metastasis in 44 patients (41.5%), and there were 35 grade T2a, 51 T2b, and 20 T3 lesions. There were 10 operation-related morbidities (9.4%) and one postoperative death (0.9%) from hepatic failure. The overall and disease-free survival rates were 81.4% and 72.4%, respectively. Tumors recurred in 17 patients (16.0%) during the follow-up periods (median 21.5 months; range 2-60). Conclusions: LAG for AGC might be considered as a minimally invasive treatment in selected cases, but further study comparing it with open gastrectomy will be needed.

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Section: Discussionmentioning

confidence: 99%

Long‐term outcomes after laparoscopy‐assisted gastrectomy for advanced gastric cancer: Analysis of consecutive 106 experiences

Lee

Kim

2009

Journal of Surgical Oncology

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“…This method was first reported by Uyama et al [17] and was modified by Wang et al [18] . Circular stapling was performed to isolate separately the esophagus and jejunum prior to anastomosis.…”

Section: Discussionmentioning

confidence: 99%

“…Knotless barbed sutures (VLoc TM ; Covidien, Mansfield, MA, United States) can reduce the time of anastomosis and can ensure the safety of anastomosis, with no need for permanent traction during the whole anastomosis procedure. 9.6 ± 1.9 (7-17) 10.1 ± 2.4 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) Data are mean ± SD (range). We recommend that the reconstruction method using a stapler should be selected on the basis of tumor location.…”

Section: Discussionmentioning

confidence: 99%

Intracorporeal esophagojejunostomy after totally laparoscopic total gastrectomy: A single-center 7-year experience

Chen

Pan

Cai

et al. 2016

WJG

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AIM:To assess the efficacy and safety of intracorporeal esophagojejunostomy in patients undergoing laparoscopic total gastrectomy (LTG) for gastric cancer. METHODS:A retrospective review of 81 consecutive patients who underwent LTG with the same surgical team between November 2007 and July 2014 was performed. Four types of intracorporeal esophagojejunostomy using staplers or hand-sewn suturing were performed after LTG. Data on clinicopatholgoical characteristics, occurrence of complications, postoperative recovery, anastomotic time, and operation time among the surgical groups were obtained through medical records. RESULTS:The average operation time was 288.7 min, the average anastomotic time was 54.3 min, and the average estimated blood loss was 82.7 mL. There were no cases of conversion to open surgery. The first flatus was observed around 3.7 d, while the liquid diet was started, on average, from 4.9 d. The average postoperative hospital stay was 10.1 d. Postoperative complications occurred in 14 patients, nearly 17.3%. Observational Study ORIGINAL ARTICLEHowever, there were no cases of postoperative death.CONCLUSION: LTG performed with intracorporeal esophagojejunostomy using laparoscopic staplers or hand-sewn suturing is feasible and safe. The surgical results were acceptable from the perspective of minimal invasiveness.

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“…Although ten LTGs were included in this study, this was not regarded as the first report, because of its small sample size and because the results were collected by a questionnaire. Since LTG was first reported as a technical note in 1999 [26], some further studies have been reported [18][19][20][21][22][23][24]. Of these, the highest number of publications has been from Japan (n = 50), followed by Korea (n = 42; see Fig.…”

Section: Annual Publicationsmentioning

confidence: 99%

A systematic review of laparoscopic total gastrectomy for gastric cancer

et al. 2015

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Background Laparoscopic total gastrectomy (LTG) has been performed since 1999. Although surgical outcomes have been reported from Japan, Korea, China, and many Western countries, the effectiveness of this technique has not been conclusively established. This study therefore aimed to review the literature systematically. Methods Our search of the research literature identified 150 studies, which were mostly retrospective and from single institutions. Results There has recently been a remarkable increase in the number of studies from Korea, and the number of patients included in studies has increased since 2009. In most studies, the surgical procedures were longer, blood loss was reduced, and the number of retrieved lymph nodes was the same in the LTG group as in the open total gastrectomy group. The incidence of postoperative complications and that of inflammation during postoperative recovery were the same in these two groups. Conclusions During LTG, the method used for esophagojejunostomy is important for surgical reliability and to reduce postoperative complications. There has been rapid development of new techniques from the level of esophagojejunostomy through a small skin incision to the high level of intracorporeal esophagojejunostomy using various techniques. A nationwide prospective phase II study is urgently needed to establish the value of LTG.

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Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer

Cited by 216 publications

References 12 publications

Long‐term outcomes after laparoscopy‐assisted gastrectomy for advanced gastric cancer: Analysis of consecutive 106 experiences

Long‐term outcomes after laparoscopy‐assisted gastrectomy for advanced gastric cancer: Analysis of consecutive 106 experiences

Intracorporeal esophagojejunostomy after totally laparoscopic total gastrectomy: A single-center 7-year experience

A systematic review of laparoscopic total gastrectomy for gastric cancer

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