Long-term Survival Outcomes of Laparoscopic Versus Open Gastrectomy for Gastric Cancer

Chen, Xin-Zu; Wen, Lu; Yang, Rui; Liu, Chao-Xu; Zhao, Qingchuan; Zhou, Zong‐Guang; Hu, Jian‐Kun

doi:10.1097/md.0000000000000454

Cited by 43 publications

(23 citation statements)

References 64 publications

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“…Additionally, we grouped the cancer types as EGC and AGC to compare LTG and OTG more precisely. In a previous meta-analysis, mixed data of gastrectomy type data (distal, proximal, and total) and blended data of tumor stage (AGC and EGC) prevented an accurate comparison between LTG and OTG [47,48]. Furthermore, we matched confounding factors including the lymph node dissection method and lymph node metastasis ratio that might influence long-term surgical outcome.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic total gastrectomy as a valid procedure to treat gastric cancer option both in early and advanced stage: A systematic review and meta-analysis

Oh¹,

Kim²,

Lee

et al. 2020

European Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 99%

Laparoscopic total gastrectomy as a valid procedure to treat gastric cancer option both in early and advanced stage: A systematic review and meta-analysis

Oh¹,

Kim²,

Lee

et al. 2020

European Journal of Surgical Oncology

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“…However, the oncological safety of laparoscopic surgery remains to be confirmed by phase III randomized trials; therefore, we will focus on the long‐term outcomes of on‐going clinical trials . Indeed, some reliable observational studies have reported the non‐inferiority of the oncological outcomes of LDG compared with ODG . We believe that this shift toward laparoscopic surgery will persist for some time, given the benefits associated with less‐invasive surgery.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcomes of laparoscopic distal gastrectomy compared to open distal gastrectomy: A retrospective cohort study based on a nationwide registry database in Japan

Yoshida

Honda

Kumamaru

et al. 2017

Annals of Gastroent Surgery

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To clarify the safety profile of laparoscopic distal gastrectomy (LDG) for gastric cancer patients, the short‐term outcome of LDG was compared to that of open distal gastrectomy (ODG) by propensity score matching using data from the Japanese National Clinical Database (NCD). We conducted a retrospective cohort study of patients undergoing distal gastrectomy between January 2012 and December 2013. Using the data for 70 346 patients registered in the NCD, incidences of mortality and morbidities were compared between LDG patients and ODG patients in the propensity score matched stage I patients (ODG: n = 14 386, LDG: n = 14 386) and stage II‐IV patients (ODG: n = 3738, LDG: n = 3738), respectively. There was no significant difference in mortality rates between LDG and ODG at all stages. Operating time was significantly longer in LDG compared to ODG, whereas blood loss and incidences of superficial surgical site infection (SSI), deep SSI, and wound dehiscence were significantly higher in ODG at all stages. Interestingly, pancreatic fistula was found significantly more often in LDG (1%) compared to ODG (0.8%) (P = .01) in stage I patients; however, it was not different in stage II‐IV patients. The length of postoperative stay was significantly longer in patients undergoing ODG compared to LDG at all stages. LDG in general practice might be a feasible therapeutic option in patients with both advanced gastric cancer and those with early gastric cancer in Japan.

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“…The long-standing discussion regarding the oncological safety of minimally invasive access was addressed in recent meta-analyses that clearly showed that it is non-inferior to open gastrectomy. In centers that routinely perform this procedure laparoscopically, the number of lymph nodes harvested and the R0 resection rate are comparable [10,19,20]. It is rather the experience of the surgeon and the center that influences clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Gastrectomy with Enhanced Recovery After Surgery Protocol: Single-Center Experience

et al. 2017

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BackgroundSurgery remains the mainstay of gastric cancer treatment. It is, however, associated with a relatively high risk of perioperative complications. The use of laparoscopy and the Enhanced Recovery After Surgery (ERAS) protocol allows clinicians to limit surgically induced trauma, thus improving recovery and reducing the number of complications. The aim of the study is to present clinical outcomes of patients with gastric cancer undergoing laparoscopic gastrectomy combined with the ERAS protocol.Material/MethodsFifty-three (21 female/32 male) patients who underwent elective laparoscopic total gastrectomy due to cancer were prospectively analyzed. Demographic and surgical parameters were assessed, as well as the compliance with ERAS protocol elements, length of hospital stay, number of complications, and readmissions.ResultsMean operative time was 296.4±98.9 min, and mean blood loss was 293.3±213.8 mL. In 3 (5.7%) cases, conversion was required. Median length of hospital stay was 5 days. Compliance with ERAS protocol was 79.6±14.5%. Thirty (56.6%) patients tolerated an early oral diet well within 24 h postoperatively; in 48 (90.6%) patients, mobilization in the first 24 hours was successful. In 17 (32.1%) patients, postoperative complications occurred, with 7 of them (13.2%) being serious (Clavien-Dindo 3-5). The 30-day readmission rate was 9.4%.ConclusionsThe combination of laparoscopy and the ERAS protocol in patients with gastric cancer is feasible and allows achieving good clinical outcomes.

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Long-term Survival Outcomes of Laparoscopic Versus Open Gastrectomy for Gastric Cancer

Abstract: Supplemental Digital Content is available in the text

Cited by 43 publications

References 64 publications

Laparoscopic total gastrectomy as a valid procedure to treat gastric cancer option both in early and advanced stage: A systematic review and meta-analysis

Laparoscopic total gastrectomy as a valid procedure to treat gastric cancer option both in early and advanced stage: A systematic review and meta-analysis

Surgical outcomes of laparoscopic distal gastrectomy compared to open distal gastrectomy: A retrospective cohort study based on a nationwide registry database in Japan

Laparoscopic Gastrectomy with Enhanced Recovery After Surgery Protocol: Single-Center Experience

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