Evaluation of the Safety and Feasibility of Laparoscopic Total Gastrectomy in Clinical Stage I Gastric Cancer Patients

2015 ◽  
Vol 39 (7) ◽  
pp. 1782-1788 ◽  
Author(s):  
Daisuke Ichikawa ◽  
Shuhei Komatsu ◽  
Takeshi Kubota ◽  
Kazuma Okamoto ◽  
Hirotaka Konishi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Total Gastrectomy ◽  
Clinical Stage ◽  
Laparoscopic Total Gastrectomy ◽  
Stage I ◽  
Gastric Cancer Patients

scholarly journals Is Totally Laparoscopic Total Gastrectomy Better Than Laparoscopy- Assisted Total Gastrectomy For Clinical Stage I Gastric Cancer? A Propensity-Score Matched Analysis

2021 ◽  
Author(s):  
Shin-Hoo Park ◽  
Yun-Suhk Suh ◽  
Tae-Han Kim ◽  
Yoon-Hee Choi ◽  
Jong-Ho Choi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Propensity Score ◽  
Learning Curve ◽  
Total Gastrectomy ◽  
Pulmonary Complication ◽  
Clinical Stage ◽  
Laparoscopic Total Gastrectomy ◽  
Stage I ◽  
Totally Laparoscopic Total Gastrectomy ◽  
Totally Laparoscopic

Abstract Background: This study aimed to evaluate the surgical outcome and quality of life (QoL) of totally laparoscopic total gastrectomy (TLTG) compared with laparoscopy-assisted total gastrectomy (LATG) in patients with clinical stage I gastric cancer.Methods: From 2012 to 2018, EGC patients who underwent TLTG (n=223), including the first case with intracorporeal hemi-double stapling, were matched to those who underwent LATG (n=114) with extracorporeal circular stapling, using 2:1 propensity score matching (PSM). Prospectively collected morbidity was compared between the TLTG and LATG groups in conjunction with the learning curve. The European Organization for Research and Treatment of Cancer (EORTC) QoL questionnaires QLQ-C30, STO22, and OG25 were prospectively surveyed during postoperative 1 year for patient subgroups.Results: After PSM, grade I pulmonary complication rate was lower in the TLTG group (n=213) than in the LATG group (n=111) (0.5% vs. 5.4%, P=0.007). Other complications were not different between the groups. The learning curve of TLTG was overcome at the 26th case in terms of the comprehensive complication index. The TLTG group after learning curve showed lower grade I pulmonary complication rate than the matched LATG group (0.5% vs. 4.7%, P=0.024). Regarding postoperative QoL, the TLTG group (n=63) revealed less dysphagia (P=0.028), pain (P=0.028), eating restriction (P=0.006), eating (P=0.004), odynophagia (P=0.023) than the LATG group (n=21). Multivariate analyses for each QoL item demonstrated that TLTG was the only common independent factor for better QoL.Conclusions: TLTG reduced pulmonary complications and provided better QoL in dysphagia, pain, eating, odynophagia than LATG for patients with clinical stage I gastric cancer.

scholarly journals AN ANALYTICAL STUDY TO ASSESS AND COMPARE OUTCOME OF CLIPPING VERSUS SUTURE LIGATION OF THE CYSTIC DUCT IN LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Lakhami Chand Sinsinwar ◽  
Rajvala Choudhary ◽  
Sanjeev Singh Choudhary ◽  
Jeevan Kankaria
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Total Gastrectomy ◽  
Laparoscopic Total Gastrectomy ◽  
Oral Feeding ◽  
Feeding Time ◽  
Early Oral Feeding ◽  
The Mean ◽  
Gastric Cancer Patients

Background: The early oral feeding after the laparoscopic total gastrectomy contributes to the enhanced treatment efficiency and improved quality of life of gastric cancer patients. To evaluate the efficiency of early oral feeding after laparoscopic total gastrectomy in gastric cancer patients at the Nghe An General Friendship Hospital. Methods: A retrospective observational study, performed in patients who underwent laparoscopic total gastrectomy from 2014 to 2020. Results: 126 patients were recruited. The mean age was 60.6 ± 11.1 years. The male/female ratio was 2.8/1. 15.9% of patients had the tumor at the one-third upper stomach, 81.7% at the middle of the stomach. 70.6% of patients contracted adenocarcinoma and ductal carcinoma, 24.6% of patients had ring cell carcinoma. The percent of tumor at stages I, II, III were respectively 19.0%, 49.2%, 31.7%. There were 71.4% of cases underwent laparoscopic total gastrectomy and were made the anastomosis by linear staplers. No case presented complications relating to the anastomosis after the surgery. The mean oral feeding time was 4.4 ± 1.9 (2 – 8 days), 27.8% of cases started at the second postoperative date, 8.7% of cases at the third postoperative date, 29.4% of cases from the fourth and fifth date, and 34.1% of cases started from the sixth date and further. The later the oral feeding time was, the slower recovery of the peristalsis was and vice versa (p < 0.05). There was no difference between the feeding time and the complications (p > 0.05). The more early the feeding time was, the shorter duration of antibiotic therapy observed and vice versa (p < 0.05). The more early the feeding time was, the short duration of hospital stay was and vice versa (p < 0.05). Conclusions: The early oral feeding after laparoscopic total gastrectomy was safe and contributed to improving the efficiency of the treatment, the quality of life in gastric cancer patients. Keywords: Early oral feeding, gastric cancer.

Long-term survival results of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: A multicenter phase II trial (JCOG 0703).

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 113-113 ◽  
Author(s):  
Mikihito Nakamori ◽  
Hitoshi Katai ◽  
Junki Mizusawa ◽  
Kenichi Nakamura ◽  
Naoki Hiki ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Distal Gastrectomy ◽  
Clinical Stage ◽  
Stage I ◽  
Phase Iii ◽  
Term Outcome ◽  
Nodal Dissection ◽  
Gastric Cancer Patients

113 Background: Laparoscopic gastrectomy has been a common tool for gastric cancer patients in eastern Asian countries. A large-scale prospective study with a sample size sufficient to investigate the benefit of laparoscopy-assisted distal gastrectomy (LADG) has never been reported. We conducted a multi-center phase II trial (JCOG0703) to evaluate the safety of LADG with nodal dissection for clinical stage I gastric cancer patients. A short-term outcome including postoperative complications of LADG as a result of this study was already reported and a following multi-center phase III trials (JCOG0912) to confirm the non-inferiority of LADG compared with open gastrectomy in terms of overall survival (OS) was already started. Long-term outcomes as the secondary endpoints of this study are reported here after 5-year follow up period. Methods: The subjects of this study comprised patients with clinical stage I gastric cancer that were able to undergo a distal gastrectomy. LADG with D1 plus suprapancreatic lymph node dissection was performed by credentialed gastric surgeons who experienced >=30 LADG and >=30 open gasterctomy. The primary endpoint was the proportion of patients who developed either anastomotic leakage or a pancreatic fistula. The secondary endpoints included surgical morbidity, short-term clinical outcome, OS, and relapse free survival (RFS). Results: Between November 2007 and September 2008, 176 eligible patients were enrolled. 140/23/9/4 patients had pStage IA/IB/II/IIIA disease respectively. No patients had recurrence. 3 patients died without recurrence. 5-year OS was 98.2% (95%CI, 94.7% to 99.4%). 5-year RFS was 98.2% (95%CI, 94.4% to 99.4%). Conclusions: The long-term outcome of LADG for Stage I gastric cancer patients seem comparable to those of open procedures. However, this result should be confirmed by a randomized control trial. We have just finished an accrual of 921 patients for a multi-center phase III trial (JCOG0912) to confirm the non-inferiority of LADG compared with open gastrectomy in terms of OS. Clinical trial information: UMIN000000874.

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