Laparoscopic versus open distal gastrectomy for advanced gastric cancer in elderly patients: a propensity-score matched analysis

Yao, Qing; Sun, Qian-Nan; Wang, Dao-Rong

doi:10.1186/s12957-023-03269-2

Cited by 3 publications

(1 citation statement)

References 27 publications

(30 reference statements)

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“…LDG and D2 lymph node dissection, when performed by experienced surgeons in high-volume specialised centres, is a safe and effective technique for patients with advanced gastric cancer and is increasingly replacing open distal gastrectomy. This laparoscopic approach may become the standard of care for locally advanced distal gastric cancer [ 27 , 28 , 29 , 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Hemidouble Stapling Technique versus Ghosting Double Stapling Technique for Esophagojejunostomy after Laparoscopic Total Gastrectomy

Senol,

Karagul

2024

JPM

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The hemidouble stapler technique (HDST) in laparoscopic intracorporeal esophagojejunostomy has aspects that pose risks to the safety of the anastomosis. We developed a new esophagojejunostomy technique that converts a double-stapled anastomosis to a single-stapled anastomosis in laparoscopic total gastrectomy (LTG). The aim of this study is to compare the results of two techniques. Patients who underwent LTG for gastric cancer in our hospital between October 2016 and May 2022 were included in the study. Patients were retrospectively reviewed in two groups: those who underwent HDST and the ghosting double stapling technique (GDST). Both groups were analysed in terms of demographics, perioperative findings, and postoperative outcomes. The GDST was used in 14 patients. The HDST was used on 16 patients. Two patients in the HDST group whose esophagojejunal anastomosis was not assessed on endoscopic imaging were excluded. The mean total operative times were 292.6 ± 43.7 and 224.3 ± 36.1 min (p < 0.001). The mean times for esophagojejunostomy were 38.6 ± 4.3 and 26.8 ± 6.4 min (p < 0.001). One case of anastomotic stenosis was observed in the HDST group. Anastomotic leakage was not observed in both groups. However, there was no significant difference in overall morbidity between the groups (p > 0.05). Both HDST and GDST can be safely performed in the esophagojejunostomy for LTG.

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Section: Discussionmentioning

confidence: 99%

Hemidouble Stapling Technique versus Ghosting Double Stapling Technique for Esophagojejunostomy after Laparoscopic Total Gastrectomy

Senol,

Karagul

2024

JPM

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Risk factors for serious postoperative complications following gastrectomy in super‐elderly patients ≥85‐years‐old with gastric cancer: A National Clinical Database study in Japan

Ueda,

Nishimura,

Inomata

et al. 2024

Annals of Gastroent Surgery

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AimThis study aimed to evaluate the technical safety and feasibility of gastrectomy for super‐elderly patients ≥85‐y‐old with gastric cancer and to clarify the risk factors for serious postoperative complications in these patients.MethodsBetween 2017 and 2020, 10,203 patients who underwent distal gastrectomy (DG) and 2580 patients who underwent total gastrectomy (TG) were reviewed from the Japanese National Clinical Database. All possible preoperative factors were used to explore the risk factors for serious postoperative complications in the super‐elderly patients with gastric cancer.ResultsFor DG, the operative mortality rate was 1.6% (162 patients), and the rate of serious postoperative complications was 7.8% (796 patients). Similarly, the mortality rate was 2.6% (67 patients), and the rate of serious complications was 11.3% (292 patients) for TG. Based on multivariate analysis, body mass index (≥25 kg/m2), activities of daily living (ADL) (partially dependent), ASA‐PS (Grade ≥3), dyspnea, ascites, history of cerebrovascular disease, serum albumin (<4 g/dL), and creatinine (>1.2 mg/dL) in DG, and ADL (partially dependent), ASA‐PS (Grade ≥3), previous percutaneous coronary intervention, dialysis, WBC (>9000 μL), and AST (>35 IU/L) in TG were strong risk factors for serious postoperative complications.ConclusionsThe study findings suggest that gastrectomy for super‐elderly gastric cancer patients is relatively safe and feasible. Surgeons need to pay special attention to physical status and past medical history than tumor factors for preventing serious postoperative complications in super‐elderly gastric cancer patients.

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Propensity score-matched analysis short- and long-term outcomes of totally laparoscopic gastrectomy for gastric cancer patients with aged 80 and older

Hu,

Xie,

Yin

et al. 2024

Preprint

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Background: Recently, totally laparoscopic gastrectomy (TLG) has emerged as a viable treatment approach for gastric cancer (GC). However, the viability and efficacy of TLG in patients aged 80 years and older have remained uncertain. Methods: We retrospectively collected data of GC patients who underwent TLG and were performed by the same lead surgeon from August 2016 to December 2019 at the first affiliated Hospital of NingBo University in China. Propensity score matching was adopted to minimize selection bias at a ratio of 1:1 to compare the elderly group (≥80 years old, Older group) and youngerly group (＜65 years old, Younger group). Patient characteristics, tumour clinicopathologic, operative findings, short-term and 5 years-term prognosis were investigated and compared between the two groups. Results: Out of 601 GC patients, 205 met the inclusion criteria (Older group, n = 31; Younger group, n = 174). The mean age in the Older group was 83.3 ± 3.2 years, whereas in the Younger group, it was 56.5 ± 7.5 years. Following propensity score analysis, 31 patients were matched each other for further analysis. The Older group exhibited lower levels of Albumin (35.2 ± 4.2 vs 38.3 ± 5.0; p=.011), Prognostic Nutritional Index (41.4 ± 5.2 vs 51.9 ± 19.4; p=.006), NRS2002 score (Nutritional Risk Screening 2002) (4.8 ± 0.9 vs 3.7 ± 0.6; p<.001), and ASA grade (p=.004) compared to the Younger group. The Older group with a longer postoperative hospital stay (26.3 ± 15.1 vs 17.7 ± 8.6; p=0.009) and higher total medical expenses (71274.1 ± 37712.6yuan vs 54520.1 ± 17003.7yuan; p=0.029) compared with the Younger group. Except for a higher incidence of pleural effusion in the Older group compared to the Younger group (p=0.022), no significant differences in other postoperative complications were observed between the two cohorts. Furthermore, no significant differences were observed in the 1-, 3-, and 5-year overall survival (OS) rates between the two groups (p=0.345, p=0.123, p=0.345, respectively). Conclusion: TLG for GC is considered viable and effective, especially when performed by experienced teams with carefully managed patients, even in patients aged 80 years and older, resulting in satisfactory short- and long-term outcomes and offering more targeted evidence for surgical approach selection in this particular age cohort.

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Laparoscopic versus open distal gastrectomy for advanced gastric cancer in elderly patients: a propensity-score matched analysis

Cited by 3 publications

References 27 publications

Hemidouble Stapling Technique versus Ghosting Double Stapling Technique for Esophagojejunostomy after Laparoscopic Total Gastrectomy

Hemidouble Stapling Technique versus Ghosting Double Stapling Technique for Esophagojejunostomy after Laparoscopic Total Gastrectomy

Risk factors for serious postoperative complications following gastrectomy in super‐elderly patients ≥85‐years‐old with gastric cancer: A National Clinical Database study in Japan

Propensity score-matched analysis short- and long-term outcomes of totally laparoscopic gastrectomy for gastric cancer patients with aged 80 and older

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