Surgical and nutritional outcomes of laparoscopic proximal gastrectomy versus total gastrectomy: a meta-analysis

Tanioka, Toshiro; Waratchanont, Rawat; Fukuyo, Ryosuke; Saito, Toshifumi; Umebayashi, Yuya; Kanemoto, Emi; Kobayashi, Kazuo; Nakagawa, Masatoshi; Inokuchi, Mikito

doi:10.1007/s00464-019-07352-2

Cited by 35 publications

(24 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sugiyama et al observed that the body weight and skeletal muscle index reduction rates were lower in the LPG-DT group than in the LTG group [42]. Recently, Tanioka et al reviewed 11 articles (336 underwent LPG and 547 underwent LTG) to evaluate surgical outcome and nutritional outcomes [43]. The LTG group had a significantly lower body weight and LPG had a weighted mean difference.…”

Section: A-loop -Afferent Loop E-loop -Efferent Loop Ej -Esophagojementioning

confidence: 99%

Totally laparoscopic proximal gastrectomy with double tract reconstruction: outcomes of 37 consecutive cases

Choi¹,

Choi²,

Ko³

et al. 2020

wiitm

View full text Add to dashboard Cite

Introduction: Proximal gastrectomy is an alternative treatment modality for gastric cancer in the upper third of the stomach. Though several reconstruction methods have been introduced, there is no standardization. We investigated the outcomes of laparoscopic proximal gastrectomy with double tract reconstruction (LPG-DTR). Aim: To investigate the outcomes of LPG-DTR. Material and methods: We evaluated 37 patients who underwent curative LPG with DTR between December 2013 and December 2018. Less than half of the proximal stomach was laparoscopically resected. We performed LPG-DTR after resection. Results: A total of 37 patients were included in this study, 25 (70%) of whom were male and 12 (30%) of whom were female. Overall, 31 (83.7%) patients were diagnosed with gastric cancer, 5 (13.5%) with gastrointestinal stromal tumors, and 1 (2.8%) with leiomyoma. There were 3 (9.6%) complications. However, there were no complications of grade 3 or above. We did not observe postoperative mortality or recurrence after surgery. All patients underwent postoperative endoscopic surveillance successfully. None of the patients had postoperative reflux esophagitis or stenosis. The body weight and hemoglobin levels of the patients were lowest 12 months after surgery and gradually increased thereafter. Similarly, their vitamin B 12 levels were lowest 6 months after surgery. However, iron been increased after surgery until 24 months after surgery. Conclusions: LPG-DTR is a favorable treatment modality for gastric cancer in the upper third of the stomach.

show abstract

Section: A-loop -Afferent Loop E-loop -Efferent Loop Ej -Esophagojementioning

confidence: 99%

Totally laparoscopic proximal gastrectomy with double tract reconstruction: outcomes of 37 consecutive cases

Choi¹,

Choi²,

Ko³

et al. 2020

wiitm

View full text Add to dashboard Cite

show abstract

“…These results indicate that PG-TVT had important advantages compared with TG. Tanioka et al also suggested that LPG may be more beneficial compared with LTG in terms of perioperative and nutritional outcomes for early-stage gastric cancer (23).…”

Section: Discussionmentioning

confidence: 99%

“…Their results indicated that LPG-DFT is a better surgical procedure for upper-third early gastric cancer compared with laparoscopic TG in terms of morbidity, postoperative hospital stay and postoperative nutritional status (22). In addition, Tanioka et al indicated that LPG may be more beneficial compared with laparoscopic TG (LTG) in terms of perioperative and nutritional outcomes for early-stage gastric cancer (23). However, the operative time was significantly longer in the LPG-DFT group due to the complexity of valvuloplasty, which requires masterful intracorporeal suturing.…”

Section: Introductionmentioning

confidence: 99%

Proximal gastrectomy with anti‑reflux anastomosis for patients with adenocarcinoma of the esophagogastric junction: The simple and safe triangle‑valve technique

et al. 2020

View full text Add to dashboard Cite

A simple and safe triangle-valve technique (TVT) was applied in proximal gastrectomy (PG) in order to prevent postoperative gastric reflux among patients with adenocarcinoma of the esophagogastric junction (AEG). The clinical outcomes were evaluated in comparison to those of canonical total gastrectomy (TG). This retrospective study of 74 AEG patients compared two surgical procedures, PG-TVT (n=44) and TG (n=30), in terms of surgical outcomes, postoperative complications and nutritional status. The Reflux Disease Questionnaire (RDQ) was used to evaluate reflux esophagitis, and patients with an RDQ score of ≥12 points were diagnosed with gastroesophageal reflux disease (GERD). The mean operative time was significantly shorter in the PG-TVT group (242.6 min) compared with that in the TG group (288.1 min). The overall postoperative complication rate did not differ significantly between the PG-TVT and TG groups. All the patients were followed up for 6 months, and none developed cancer recurrence in distant organs, gastric remnant, or lymph nodes. The GERD incidence was similar between the PG-TVT and TG groups. The mean levels of total protein and albumin within 6 months were significantly higher in the PG-TVT group compared with those in the TG group after adjustingtthe time effect and the interaction of time and surgical methods. The level of total protein significantly increased within 6 months in the PG-TVT group, but decreased in the TG group. Therefore, PG-TVT has several advantages over TG for patients with AEG, including a shorter operative time and better postoperative nutritional status, whereas the incidence of GERD was found to be similar between the two techniques.

show abstract

“…Open total gastrectomy yields a higher risk of post-surgical malnutrition because of longer transition periods from a liquid diet to a normal diet with an insufficient caloric intake, limited absorption of nutrients, reflux esophagitis, and dumping syndrome. Laparoscopic gastric resection, on the other side, could reduce the surgical trauma, the incidence of postoperative complications (especially pulmonary infections), may assure a faster recovery, and may become an optional surgical method for underweight patients with preoperative malnutrition [ 66 , 72 , 73 ]. Considering the frequency of exocrine pancreatic insufficiency secondary to total gastrectomy, patients should be routinely screened for steatorrhea, and a pancreatic enzyme supplementation should be administered especially in those patients who apparently meet their nutritional requirements but do not reach a body weight stabilization and nutritional parameters improvement [ 74 , 75 ].…”

Section: Nutritional Support Strategiesmentioning

confidence: 99%

Nutritional Support Indications in Gastroesophageal Cancer Patients: From Perioperative to Palliative Systemic Therapy. A Comprehensive Review of the Last Decade

et al. 2021

View full text Add to dashboard Cite

Gastric cancer treatments are rapidly evolving, leading to significant survival benefit. Recent evidence provided by clinical trials strongly encouraged the use of perioperative chemotherapy as standard treatment for the localized disease, whereas in the advanced disease setting, molecular characterization has improved patients’ selection for tailored therapeutic approaches, including molecular targeted therapy and immunotherapy. The role of nutritional therapy is widely recognized, with oncologic treatment’s tolerance and response being better in well-nourished patients. In this review, literature data on strategies or nutritional interventions will be critically examined, with particular regard to different treatment phases (perioperative, metastatic, and palliative settings), with the aim to draw practical indications for an adequate nutritional support of gastric cancer patients and provide an insight on future directions in nutritional strategies. We extensively analyzed the last 10 years of literature, in order to provide evidence that may fit current clinical practice both in terms of nutritional interventions and oncological treatment. Overall, 137 works were selected: 34 Randomized Clinical Trials (RCTs), 12 meta-analysis, 9 reviews, and the most relevant prospective, retrospective and cross-sectional studies in this setting. Eleven ongoing trials have been selected from clinicaltrial.gov as representative of current research. One limitation of our work lies in the heterogeneity of the described studies, in terms of sample size, study procedures, and both nutritional and clinical outcomes. Indeed, to date, there are no specific evidence-based guidelines in this fields, therefore we proposed a clinical algorithm with the aim to indicate an appropriate nutritional strategy for gastric cancer patients.

show abstract

Surgical and nutritional outcomes of laparoscopic proximal gastrectomy versus total gastrectomy: a meta-analysis

Cited by 35 publications

References 28 publications

Totally laparoscopic proximal gastrectomy with double tract reconstruction: outcomes of 37 consecutive cases

Totally laparoscopic proximal gastrectomy with double tract reconstruction: outcomes of 37 consecutive cases

Proximal gastrectomy with anti‑reflux anastomosis for patients with adenocarcinoma of the esophagogastric junction: The simple and safe triangle‑valve technique

Nutritional Support Indications in Gastroesophageal Cancer Patients: From Perioperative to Palliative Systemic Therapy. A Comprehensive Review of the Last Decade

Contact Info

Product

Resources

About