Laparoscopy-Assisted Distal Gastrectomy for Gastric Cancer

Kiyama, Teruo; Fujita, Itsuo; Kanno, Hitoshi; Tani, Aya; Yoshiyuki, Toshiro; Kato, Shunji; Tajiri, Takashi; Barbul, Adrian

doi:10.1007/s11605-008-0599-3

Cited by 10 publications

(10 citation statements)

References 15 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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“…In most studies, the authors concluded that LADG was comparable to or sometimes better than ODG in terms of postoperative clinical outcomes [3,9,12,13,14,15,16,17]. Although recent studies revealed that age, sex, and BMI were important factors that influence the outcome of surgery, few studies that controlled these factors have been published.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopy-Assisted Distal Gastrectomy Compared to Open Distal Gastrectomy in Early Gastric Cancer

Han

Lee²,

Han³

et al. 2011

Dig Surg

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Background: This study aimed to evaluate the feasibility of laparoscopy-assisted distal gastrectomy (LADG) in early gastric cancer (EGC) with special interest in a learning curve effect. Methods: The clinical outcomes of EGC patients who underwent LADG (n = 100) and sex-, age- and body mass index- (BMI) matched EGC patients who underwent open distal gastrectomy (ODG; n = 100) were compared retrospectively. In addition, the outcomes between the early (n = 50) and late LADG group (n = 50) were compared. Results: The mean number of retrieved lymph nodes was significantly smaller in the LADG group than in the ODG group (29.3 vs. 36.4, p < 0.001). The operative time of the LADG group was significantly longer than in the ODG group (249.1 vs. 152.9 min, p < 0.001). The complication rates were comparable between both groups (14 vs. 13%, p = 0.84). No cancer-related death was observed in either group. Between early and late LADG groups, the operative time was shorter (p < 0.001) and the number of retrieved lymph nodes was higher (p = 0.016) in the late group. Conclusions: LADG seems to be a safe and feasible procedure in treating EGC, as it shows comparable outcomes with ODG. The potential disadvantages of LADG, such as longer operation time and smaller number of retrieved lymph nodes, diminished after overcoming the learning curve.

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“…For mucosal EGC, a D1 dissection with removal of 1 and 3-6 stations according to JGCA is adequate [1,33], the same as in a modified D2 dissection for mucosal or submucosal EGC [36]. For EGC of the lower third, distal gastrectomy is generally performed [15,17,19,21,22,24,25,29,36], but SG with a 6-cm safety margin has been described also [10,13,26], mainly for the possible presence of multifocal cancer [37]. As a result of our policy, all of the patients cured of EGC have the resection margins free of disease and all but one with Pen A tumor are alive and disease-free in the follow-up.…”

Section: Respect Of Oncologic Principlesmentioning

confidence: 99%

“…Adversely, invasiveness through the gastric wall is sometimes underestimated during the preoperative workup; thus, the role of D2 nodal clearance in EGC has been emphasized [3,[8][9][10]. That laparoscopy can be feasible and effective in the treatment of gastric cancer is apparent from the results in many articles [8,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25], some of which compare also AGC data on survival [10,12,13,15,19,24]. Robotics can improve a surgeon's dexterity and may be especially helpful during maneuvers in restricted fields such as in extended lymphadenectomy [16,[26][27][28][29].…”

mentioning

confidence: 99%

Subtotal gastrectomy with D2 dissection by minimally invasive surgery for distal adenocarcinoma of the stomach: results and 5-year survival

et al. 2010

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Laparoscopy-Assisted Distal Gastrectomy for Gastric Cancer

Abstract: The authors conclude that laparoscopy-assisted distal gastrectomy is a safe and useful operation for early-stage gastric cancers. If patients are selected properly, laparoscopy-assisted distal gastrectomy can be a curative and minimally invasive treatment for gastric cancer.

Cited by 10 publications

References 15 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

Laparoscopy-Assisted Distal Gastrectomy Compared to Open Distal Gastrectomy in Early Gastric Cancer

Subtotal gastrectomy with D2 dissection by minimally invasive surgery for distal adenocarcinoma of the stomach: results and 5-year survival

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