Limited subtotal gastrectomy for early remnant gastric cancer

Hosokawa, Yuichi; Konishi, Masaru; Sahara, Yoshinori; Kinoshita, Takahiro; Takahashi, Shinichiro; Gotohda, Naoto; Kato, Yukio; Kinoshita, Taira

doi:10.1007/s10120-013-0280-8

Cited by 9 publications

(9 citation statements)

References 22 publications

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“…Because of anatomical alterations and intra-abdominal adhesions, surgical treatments for GSC are difficult and are associated with relatively high rates of morbidity and mortality [7]. Yuichi Hosokawa et al [15] and Tomoyuki Irino et al [16] found a similar frequency of complications in the SG and TG groups for GSC. In the present study, we also found that the rate of complications was similar in the two groups; however, there were three cases of anastomotic leakage in the TG group and no cases of anastomotic leakage in the SG group.…”

Section: Discussionmentioning

confidence: 99%

“…Seung Lee et al investigated long-term differences in QoL after SG and TG by comparing two groups and found an inferior QoL stemming from symptomatic and behavioral consequences of surgery in survivors 5 years after TG [27]. Regarding GSC, Yuichi Hosokawa et al [15] compared SG and TG for GSC in 13 and 22 patients, respectively, and found that three patients in the TG group developed dumping syndrome, while no patients in the SG group developed dumping syndrome. Additionally, the hemoglobin and total protein levels were higher in the SG group than in the TG group 1 year after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…In our hospital, we also perform subtotal gastrectomy (SG) of the gastric stump for patients with GSC located at the anastomotic site following distal gastrectomy for benign disease. To the best of our knowledge, only three studies have demonstrated that SG of the gastric stump is feasible for patients with early GSC [15][16][17]. All previous studies investigating the feasibility of SG for GSC were limited to the early stage of the disease.…”

Section: Introductionmentioning

confidence: 99%

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Is subtotal gastrectomy feasible for the treatment of gastric stump cancer located at the anastomotic site after distal gastrectomy for benign lesions?

Yang

et al. 2020

World J Surg Onc

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Background: Total gastrectomy (TG) is a widely accepted procedure for treating gastric stump cancer (GSC). However, subtotal gastrectomy (SG) would benefit elective patients with GSC. The aim of this study was to clarify the safety and long-term prognosis of SG in treating GSC after distal gastrectomy for benign lesions. Methods: A total of 53 patients with GSC located at the anastomotic site or gastric body between May 1999 and December 2018 at our hospital were included. In total, 21 patients underwent SG, and the remaining 24 patients underwent TG. Clinicopathological data, operative data, and overall survival (OS) were compared. Results: The operative duration, estimated blood loss volume, and length of hospital stay were similar between the SG and TG groups. The postoperative complications were similar between the two groups, but no cases of anastomotic leakage were noted in the SG group. TG was associated with significantly more retrieved lymph nodes than SG (18.5 ± 11.5 vs. 10.7 ± 9.2; p = 0.017), while the number of metastatic lymph nodes did not differ between the groups (2.9 ± 3.5 vs. 1.9 ± 3.6; p = 0.329). The median survival time in the SG group was 81.0 months (95% confidence interval (CI), 68.906 to 93.094 months), which was similar to the 45.0 months (95% CI, 15.920 to 74.080 months) observed in the TG group (p = 0.236). Both univariate and multivariate analyses showed that tumor location and histological type were prognostic factors, while surgery type was not a prognostic factor. Further stratified analyses according to tumor location revealed that OS was not significantly different between the two groups among patients with tumors located at the anastomotic site, while OS in the TG group was significantly better than that in the SG group among patients with tumors located in the gastric body (p = 0.046). Conclusions: The results of the current study indicate that SG is a suitable alternative surgical procedure for GSC located at the anastomotic site after distal gastrectomy for benign lesions. The short-term outcomes and long-term prognoses of SG are comparable with those of TG.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is subtotal gastrectomy feasible for the treatment of gastric stump cancer located at the anastomotic site after distal gastrectomy for benign lesions?

Yang

et al. 2020

World J Surg Onc

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“…Furthermore, all of these questionnaires are thought to lack sensitivity to treatment interventions, indicating the need for a specific patient-reported outcome questionnaire to be developed for dumping syndrome. There is agreement that the modified OGTT is the preferred diagnostic method (statement 33), and diagnostic parameters for early and late dumping syndrome are well established (statements [34][35][36]. The same glycaemia level cut-off (50 mg/dl) is proposed for spontaneous glycaemia levels and for late hypoglycaemia during the modified OGTT for supporting the diagnosis of dumping syndrome (statements 28, 29, 35 and 36).…”

Section: Recommendationsmentioning

confidence: 99%

International consensus on the diagnosis and management of dumping syndrome

Arts²,

et al. 2020

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Dumping syndrome is a frequent complication of cancer and non-cancer oesophageal and gastric surgery, as well as bariatric surgery (also known as metabolic surgery). These interventions change gastric anatomy and innervation, which can enable a considerable amount of undigested food to reach the small intestine too rapidly 1-4. Dumping syndrome comprises a constellation of symptoms that can be subdivided into early and late dumping syndrome symptoms, which can occur jointly or separately 1-8. Typically, symptoms of early dumping syndrome occur within the first hour after a meal and include gastrointestinal symptoms (abdominal pain, bloating, borborygmi, nausea and diarrhoea) and vasomotor symptoms (flushing, palpitations, perspiration, tachycardia, hypotension, fatigue, desire to lie down and, rarely, syncope) 1,2. The underlying mechanisms might involve osmotic effects, peptide hormone release and autonomic neural responses 1. Symptoms of late dumping syndrome usually occur between 1 and 3 h after a meal and are primarily the manifestations of hypoglycaemia, which mainly results from an incretin-driven hyperinsulinaemic response after carbohydrate ingestion. Hypoglycaemia-related symptoms are attributable to neuroglycopenia (which is indicated by fatigue, weakness, confusion, hunger and syncope) and to vagal and sympathetic activation (indicated by perspiration, palpitations, tremor and irritability) 1,2. The literature has referred to late dumping syndrome as 'reactive hypoglycaemia' or, after bariatric surgery, as 'postbariatric hypoglycaemia'. However, on the basis of a common pathophysiology of rapid exposure of the small intestine to nutrients, which is also seen in early dumping syndrome (see subsequent discussion), we refer to this phenomenon as 'late dumping syndrome'. The prevalence of dumping syndrome depends on the type and extent of surgery, and on the criteria used to diagnose dumping syndrome. Dumping syndrome occurs in approximately 20% of patients undergoing

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“…Em relação as recidivas, a recorrência em linfonodos mediastinais foi de dois pacientes dos treze que tiveram recidivas no mediastino, observando um melhor controle loco-regional. Hosokawa et al 91…”

Section: Análise Estatísticaunclassified