Laparoscopic Versus Open Gastrectomy With D2 Lymph Node Dissection for Gastric Cancer

H, Wei; Wei, Bo; Qi, Cuiling; Chen, Tufeng; Huang, Yong; Zheng, Zongheng; Huang, Jian; Fang, Jiafeng

doi:10.1097/sle.0b013e31822d02dc

Cited by 53 publications

(45 citation statements)

References 25 publications

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“…In our experience, even serosa-positive cancer (T4a) patients treated using MIS experienced similar survival and recurrence outcomes, compared to open surgery 15. The results of a meta-analysis demonstrated that compared with open surgery, laparoscopic gastrectomy with D2 LN dissection had similar overall survival rates, comparable numbers of retrieved LNs, less blood loss, less pain, reduced postoperative complications, and shorter hospital stays 41. However, the reduced postoperative complication rate resulted from a decreased incidence of minor complications (e.g., wound infections and postoperative ileus), but the incidence of major complications was similar to open surgery 41.…”

Section: Mis For Agcmentioning

confidence: 73%

“…The results of a meta-analysis demonstrated that compared with open surgery, laparoscopic gastrectomy with D2 LN dissection had similar overall survival rates, comparable numbers of retrieved LNs, less blood loss, less pain, reduced postoperative complications, and shorter hospital stays 41. However, the reduced postoperative complication rate resulted from a decreased incidence of minor complications (e.g., wound infections and postoperative ileus), but the incidence of major complications was similar to open surgery 41. Recently, large-scale multicenter RCTs began enrollment of patients to assess the feasibility of MIS for AGC in Korea, Japan, and China (Table 2).…”

Section: Mis For Agcmentioning

confidence: 99%

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Minimally Invasive Surgery for Gastric Cancer Treatment: Current Status and Future Perspectives

2014

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Minimally invasive surgery, which has been extensively used to treat gastric adenocarcinoma, is now regarded as one of the standard treatments for early gastric cancer, and its suitability for advanced gastric cancer is being investigated. The use of cutting-edge techniques for minimally invasive surgery enables surgeons to deliver various treatment options to minimize a patient's distress and to maintain oncologic safety. Ongoing multicenter prospective studies aim to validate the efficacy of these surgical techniques and to expand the indications of minimally invasive surgery for the treatment of gastric cancer. In this review, we summarize the current status and issues regarding minimally invasive surgery for the treatment of gastric cancer.

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Section: Mis For Agcmentioning

confidence: 73%

Section: Mis For Agcmentioning

confidence: 99%

Minimally Invasive Surgery for Gastric Cancer Treatment: Current Status and Future Perspectives

2014

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“…Opponents of this technique question the oncological quality of the procedure compared to the classical approach. Comparison of laparoscopic and classical methods concluded that the number of lymph nodes removed during the operation is similar regardless of preferred technique [9–11]. Histopathological evaluation in all abovementioned operations proved them to be radical, and lymphangiectomy included lymph nodes from the D2 group.…”

Section: Discussionmentioning

confidence: 99%

Enhanced recovery (ERAS) protocol in patients undergoing laparoscopic total gastrectomy.

Pędziwiatr

Matłok

Kisialeuski

et al. 2014

Videosurgery and Other Miniinvasive Techniques

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IntroductionLaparoscopic technique combined with the ERAS (Enhanced Recovery after Surgery) protocol enables a shorter hospital stay and a lower complication rate. Although it has been widely used in many patients undergoing elective abdominal surgery, especially in patients with colorectal cancer, there are only a few papers describing laparoscopic total gastrectomy and the enhanced recovery protocol in patients with gastric cancer. Minimally invasive gastrectomy is still an uncommon procedure, mostly because of its difficulty.AimTo present the preliminary results of treatment of patients with gastric neoplasms who underwent laparoscopic gastrectomy D2 with perioperative care according to ERAS principles.Material and methodsEleven patients (5 male and 6 female, age 52–77 years) underwent laparoscopic D2 gastrectomy with intracorporeal esophagojejunal anastomosis. In all patients the ERAS protocol was implemented. We analyzed operation time, complications and hospital stay. Additionally we focused on operative technique as well as the perioperative care protocol.ResultsThe mean duration of the procedure was 245 min. There was 1 conversion due to unclear tumor infiltration. Mean hospital stay was 4.6 days. One postoperative complication (central venous catheter sepsis) was reported. Histological analysis confirmed the tentative diagnosis (R0 resection) in 10/11 patients. There were no readmissions.ConclusionsLaparoscopic gastrectomy is a valuable alternative to the classical approach and combined with the ERAS protocol can result in reduced hospital stay. However, due to the small group of patients it is difficult to adequately assess the incidence of early and late complications of the laparoscopic procedures; therefore further research is needed.

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“…Majority of them reported that LS was associated with less blood loss, faster recovery of patients, less pain, shorter hospital stay as well as longer operation time (12)(13)(14)(15)(16). Some meta-analysis also demonstrated similar results (17). In terms of long-term outcomes of prospective randomized studies, only that of small samplesized studies is available.…”

Section: Previous Studies and Current Ongoing Multiinstitutional Largmentioning

confidence: 94%

Current status and future perspectives of laparoscopic radical surgery for advanced gastric cancer

Kinoshita

Kaito

2017

Transl. Gastroenterol. Hepatol.

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Laparoscopic radical gastrectomy with lymph node dissection has widely penetrated to East Asian countries, where incidence of gastric cancer occurrence is higher than the rest of the world. Laparoscopic distal gastrectomy for cStageI disease is regarded as one of the option in daily practice in the latest Japanese guidelines; however its applicability to more advanced disease (Stage II/III) is still under debate. Actually, operative techniques of laparoscopic D2 dissection is being matured, but still, necessity of total omentectomy, splenic hilar dissection, management of bulky nodes or large primary tumor, high-level anastomosis in esophageal invasion cases, and extensive peritoneal lavage can be raised as technical limitations. In the future perspective, further technological innovation, including next generation surgical robot, may help surgeons overcome these difficulties. Currently, three large-scaled randomized phase-III clinical trials are ongoing in East Asia, in which patients' accruals have been already completed. With coming long-term outcomes of these well-designed studies, oncological validity of laparoscopic approach will be adequately elucidated.

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Laparoscopic Versus Open Gastrectomy With D2 Lymph Node Dissection for Gastric Cancer

Cited by 53 publications

References 25 publications

Minimally Invasive Surgery for Gastric Cancer Treatment: Current Status and Future Perspectives

Minimally Invasive Surgery for Gastric Cancer Treatment: Current Status and Future Perspectives

Enhanced recovery (ERAS) protocol in patients undergoing laparoscopic total gastrectomy.

Current status and future perspectives of laparoscopic radical surgery for advanced gastric cancer

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