Safety and feasibility of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG 0703)

Katai, Hitoshi; Sasako, Mitsuru; Fukuda, Haruhiko; Nakamura, Kenichi; Hiki, Naoki; Saka, Makoto; Yamaue, Hiroki; Yoshikawa, Takaki; Kojima, Kazuyuki

doi:10.1007/s10120-010-0565-0

Cited by 307 publications

(234 citation statements)

References 24 publications

(33 reference statements)

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“…The feasibility and non‐inferiority of laparoscopic gastrectomy have been compared with those of conventional open surgery. A phase‐II clinical trial of early‐stage gastric cancer (JCOG 07033) has shown that the incidences of anastomotic leakage and pancreatic fistula formation were acceptably low. Kim et al .…”

Section: Resultsmentioning

confidence: 99%

“…Albeit recent advancements in surgical techniques and perioperative care, the postoperative morbidity rate is as high as approximately 40% after esophageal cancer surgery,1, 2 and 20–30% after both gastric cancer surgery3, 4, 5 and colorectal surgery 6, 7, 8. Various reports have shown that such postoperative complications frequently reduce the overall survival (OS) as well as cancer‐specific survival after major surgery for cancer 9.…”

Section: Introductionmentioning

confidence: 99%

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Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Shimada

Fukagawa

Haga

et al. 2017

Annals of Gastroent Surgery

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PurposeThe impact of postoperative complications on survival after radical surgery for esophageal, gastric, and colorectal cancers remains controversial. We conducted a systematic review of recent publications to examine the effect of postoperative complications on oncological outcome.MethodsA literature search of PubMed/MEDLINE was performed using the keywords “esophageal cancer,” “gastric cancer,” and “colorectal cancer,” obtaining 27 reports published online up until the end of April 2016. Articles focusing on (i) postoperative morbidity and oncological outcome; and (ii) body mass index (BMI), postoperative morbidity, and oncological outcome, were selected. Univariate and multivariate analyses (Cox proportional hazards model) were performed.ResultsPatients with postoperative complications had significantly poorer long‐term survival than those without complications. Complications were associated with impaired oncological outcomes. The hazard ratios for overall survival were 1.67 (95% confidence interval [CI], 1.31‐2.12), 1.59 (95% CI, 1.13‐2.24), and 1.55 (95% CI, 1.28‐1.87) in esophageal, gastric, and colorectal cancers, respectively. High BMI was associated with postoperative morbidity rate but not with poor oncological outcome. Low BMI was significantly associated with inferior oncological outcome.ConclusionsComplications after radical surgery for esophageal, gastric, and colorectal cancers are associated with patient prognosis. Avoiding such complications might improve the outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Shimada

Fukagawa

Haga

et al. 2017

Annals of Gastroent Surgery

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“…A multicenter phase II study has demonstrated that LADG can be performed safely by surgeons with sufficient experience [4]. Large-scale phase III trials of LADG versus open distal gastrectomy for clinical stage I gastric cancer are now ongoing in Japan and Korea.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of laparoscopy-assisted total gastrectomy in patients with clinical stage I gastric cancer

et al. 2013

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Background Laparoscopy-assisted total gastrectomy (LATG) for gastric cancer is not yet widespread because of the technical difficulty of reconstruction. We have performed LATG on 100 patients with clinical stage I gastric cancer. This study investigated the short-term outcomes of LATG. Methods Between September 2001 and September 2012, 100 patients with clinical stage I gastric cancer underwent LATG with D1 plus beta or D2 lymphadenectomy. Roux-en-Y esophagojejunostomy was performed intracorporeally using end-to-side anastomosis with a circular stapler (the purse-string suture method). The primary endpoint was the proportion of postoperative complications during hospitalization. Results Mean operation time was 249 min; mean blood loss was 182 ml. There were no conversions to open surgery. According to the Clavien-Dindo classification, there were 8 grade II (8 %) and 10 grade IIIa/b (10 %) complications. There were no treatment-related deaths or grade IV complications. The most frequent complication was anastomotic or stump leakage (6 %), followed by pancreatic fistula (5 %). Reoperations were required in two patients with leakage. Conclusions The short-term outcomes of LATG in our study involving 100 patients were outlined. LATG for gastric cancer patients should be attempted preferably in a clinical trial setting by surgeons with sufficient experience in laparoscopic gastrectomy.

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“…Laparoscopic distal gastrectomy (LDG) has been widely accepted as a minimally invasive and safe procedure for operating on gastric cancer located in the middle and lower stomach [1,2]. Prospective randomized clinical studies have reported better cosmesis and postoperative quality of life, less postoperative pain and complications, shorter hospital stay, and faster postoperative recovery following LDG compared with open gastrectomy [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

A comparison between fentanyl plus celecoxib therapy and epidural anesthesia for postoperative pain management following laparoscopic gastrectomy

et al. 2015

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Purpose To clarify the efficacy of postoperative pain management following laparoscopic gastrectomy (LG), we retrospectively compared pain assessments in patients who received fentanyl plus celecoxib with those who received epidural anesthesia. Results No significant difference in the severity of postoperative pain on postoperative day (POD) 0 or 1 was observed between the two groups. In contrast, pain was significantly lower in Group-FC than Group-E on POD 2, 3, 4, and 7. The total use of rescue pain medications during the first 7 days following LG did not differ between the two groups. Methods ConclusionPain management using 24 hours of intravenous fentanyl and 4 days of oral celecoxib is comparable to epidural anesthesia following LG.

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Safety and feasibility of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG 0703)

Cited by 307 publications

References 24 publications

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Feasibility of laparoscopy-assisted total gastrectomy in patients with clinical stage I gastric cancer

A comparison between fentanyl plus celecoxib therapy and epidural anesthesia for postoperative pain management following laparoscopic gastrectomy

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