Efficacy of Prophylactic Drain Placement in Laparoscopic Total Gastrectomy: A Retrospective Study

The aim of this study was to assess the efficacy of prophylactic drain placement in laparoscopic total gastrectomy (LTG). Ninety-four patients with gastric cancer who underwent LTG between December 2007 and December 2014 were enrolled in this study. A tube drain was placed in 29 patients after considering it necessary by operators, whereas no tube drain was placed in remaining patients. All patients were classified into either the drain or the no-drain group and were investigated for clinical characteristics and surgical outcomes. Overall, complications occurred in 15 patients and were not significantly different between the drain and no-drain groups [5 (17.2%) versus 10 (15.4%) patients]. No significant difference was observed in median duration of postoperative hospital stay between the drain and no-drain groups (12 versus 12 days). There was no significant difference in the duration of hospital stay regardless of the presence of drains in both groups of patients who developed complications (with drain: 27 days versus without drain: 21.5 days) and those who did not develop complications (with drain: 12 days versus without drain: 12 days). In conclusion, on the basis of the results of this study, routine prophylactic drain placement in LTG may not be necessary because it does not offer any additional benefits for patients.

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Our experience with laparoscopic total gastrectomy for gastric cancer: A case series

Journal of Gastric Surgery ◽

10.36159/jgs.v2i3.52 ◽

2020 ◽

Vol 2 (3) ◽

Author(s):

Manash Ranjan Sahoo ◽

Satyajit Samal ◽

Jyotirmay Nayak

Keyword(s):

Gastric Cancer ◽

Blood Loss ◽

Hospital Stay ◽

Total Gastrectomy ◽

Median Time ◽

Operative Time ◽

Laparoscopic Total Gastrectomy ◽

Oral Feeding ◽

Care Hospital ◽

Intraoperative Blood Loss

Background: Though laparoscopic distal gastrectomy has become a standard procedure for treatment of gastric cancer, laparoscopic total gastrectomy has not been widely accepted as it requires more dexterity and lack of evidence about its feasibility and safety. Methods: Here retrospectively we review a series of 12 cases of gastric cancer undergone laparoscopic total gastrectomy with D1 or D2 lymphadenectomy over a period of 7 years at a tertiary care hospital. The patient demographic characteristics were reviewed and the outcomes after surgery was analyzed in terms of extent of lymphadenectomy, mean operative time, mean intraoperative blood loss median number of lymph nodes harvested, median time for postoperative ambulation, median time for postoperative oral feeding, median time of postoperative hospital stay, postoperative complications and mortality. Results: All patients had total gastrectomy entirely through laparoscopic method. Mean operative time was 282 minutes, mean intraoperative blood loss was 120 ml, median time for ambulation and oral feeding was 3 days and 6 days respectively. Median time of hospital stay was 16 days and 2 patients had complications as pancreatic fistula and port site abscess. No mortality was observed. Conclusion: With zero mortality and accepted rate of complications, laparoscopic total gastrectomy appears to be technically feasible and safe for management of gastric cancer. But more studies have to be conducted with comparison to other standard gastrectomies and long term follow up to be done to establish its standardized application.

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Application of Self-Pulling and Latter Transection in Totally Laparoscopic Total Gastrectomy

10.21203/rs.3.rs-150879/v1 ◽

2021 ◽

Author(s):

Yang Zhao ◽

Zhi-Xia Bai ◽

Tao Wang ◽

Dong Song ◽

Tao Li

Keyword(s):

Gastric Cancer ◽

Total Gastrectomy ◽

Operation Time ◽

Bed Rest ◽

Laparoscopic Total Gastrectomy ◽

Time In Bed ◽

Significant Difference ◽

Totally Laparoscopic Total Gastrectomy ◽

Latter Transection ◽

Totally Laparoscopic

Abstract Background: To investigate the safety and efficacy of self-pulling and latter transection in totally laparoscopic total gastrectomy (SPLT-TLTG). Methods: Eighty patients with gastric cancer who received either SPLT-TLTG or laparoscopic-assisted total gastrectomy (LATG) were enrolled for this study from January 2016 to June 2018. Clinical data including clinicopathologic parameters, postoperative conditions and long-term prognosis were collected and compared between patients received different types of surgeries. Results: Compared to LATG, patients who received SPLT-TLTG surgery were associated with shorter operation time, less intraoperative blood loss and smaller incision lesion. In addition, patients who received SPLT-TLTG surgeries spent significantly less time in bed-rest post-surgically, to first bowel movement, hospital stay and before first oral food-intake (P < 0.05), as long as lower postoperative pain scores. However, no significant difference was observed between SPLT-TLTG and LATG surgeries in terms of how many lymph nodes (LNs) were retrieved during operation, as well as the overall incidence of postoperative complications (P > 0.05). Conclusions: This pilot study provided primary evidence for the application of self-pulling and latter transection in totally laparoscopic total gastrectomy in the treatment of gastric cancer.

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Enhanced recovery after surgery (ERAS) decreases recovery time and improve the recovery effect versus for elective gastric cancer surgery: a single-center randomized controlled trial

10.21203/rs.3.rs-416991/v1 ◽

2021 ◽

Author(s):

Shuhong Lv ◽

Xin Fan ◽

Yan Li ◽

Jinling Yan ◽

Jing Xu ◽

...

Keyword(s):

Gastric Cancer ◽

Hospital Stay ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Controlled Trial ◽

Cohort Analysis ◽

Postoperative Recovery ◽

Postoperative Hospital Stay ◽

Walking Distance ◽

Significant Difference

Abstract Background Enhanced recovery after surgery (ERAS) can help patients improve recovery speed, improve patient satisfaction, reduce postoperative pressure and reduce postoperative hospital stay. This study evaluated ERAS feasibility and effectiveness compared with conventional perioperative care and their significance in gastrectomy for patients with gastric cancer. Methods This article is a prospective cohort analysis of 272 patients. This paper investigates tumor morphology, operation information, exhaustion time, ambulation time, walking distance on the operation day and 1 day, 2 days and 3 days after the operation, While blood test indexes related to postoperative recovery and postoperative complications are evaluated. Results The recovery of gastrointestinal function was faster in ERAS patients. There was a significant difference in the time of first exhaust between ERAS group and CC group (54.60 ± 17.41 h vs. 76.71 ± 9.47 h; P < 0.001). There were significant differences in the amount of diet on the day of operation, 1 day, 2 days and 3 days after operation between the two groups (P < 0.001); There was a significant difference in the time of first ambulation between eras group and CC group (1.14 ± 0.76 D vs. 2.74 ± 0.98 D; P < 0.001). There were significant differences in walking distance between the two groups at operation day, 1 day, 2 days and 3 days after operation (P < 0.001). The postoperative hospital stay in the ERAS group was significantly shorter than that in the routine perioperative nursing group (8.38 ± 1.68 D, 11.18 ± 1.38 D; P < 0.001). Conclusion ERAS can reduce the stress after radical resection of gastric cancer, promote intestinal recovery, reduce pain intensity, and improve the recovery ability and satisfaction of patients.

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

World Journal of Surgery ◽

10.1007/s00268-015-3008-6 ◽

2015 ◽

Vol 39 (7) ◽

pp. 1782-1788 ◽

Cited By ~ 7

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

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Hand-Assisted Laparoscopic Total Gastrectomy for Early Gastric Cancer

Surgical Laparoscopy Endoscopy & Percutaneous Techniques ◽

10.1097/00129689-200310000-00002 ◽

2003 ◽

pp. 304-307 ◽

Cited By ~ 21

Author(s):

Shinsuke Usui ◽

Haruhiro Inoue ◽

Tatsuya Yoshida ◽

Norio Fukami ◽

Shin-ei Kudo ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Total Gastrectomy ◽

Laparoscopic Total Gastrectomy

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Đánh giá kết quả phẫu thuật nội soi hoàn toàn và phẫu thuật nội soi hỗ trợ cắt toàn bộ dạ dày nạo vét hạch D2 do ung thư

Journal of Clinical Medicine- Hue Central Hospital ◽

10.38103/jcmhch.2021.74.2 ◽

2021 ◽

Author(s):

Van Huong Nguyen

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Total Gastrectomy ◽

Lymph Node Dissection ◽

Laparoscopic Total Gastrectomy ◽

Node Dissection ◽

Female Ratio ◽

D2 Lymph Node Dissection ◽

Totally Laparoscopic Total Gastrectomy ◽

Totally Laparoscopic

TÓM TẮT Đặt vấn đề: Nghiên cứu nhằm đánh giá kết quả phẫu thuật nội soi hoàn toàn và phẫu thuật nội soi hỗ trợ cắt toàn bộ dạ dày nạo vét hạch D2 do ung thư tại Bệnh viện Hữu nghị Đa khoa Nghệ An. Phương pháp: Nghiên cứu mô tả hồi cứu, gồm 126 bệnh nhân ung thư dạ dày được phẫu thuật nội soi hoàn toàn và phẫu thuật nội soi hỗ trợ cắt toàn bộ dạ dày vét hạch D2, từ 2013 đến 2020 Kết quả: Tuổi trung bình 60,6 ± 11,1 tuổi. Tỷ lệ nam/nữ 2.8/1. Ung thư ở giai đoạn I, II, III là 19,0%, 49,2%, 31,7%. Ung thư biểu mô tuyến nhú và ống là 70,6% và tế bào nhẫn là 24,6%. Tỷ lệ tai biến trong mổ của nhóm PTNS hoàn toàn là 4,4% và PTNS hỗ trợ 20,6%. Số hạch nạo vét được trung bình của 2 nhóm PTNS hoàn toàn là 23,7 ± 7,1 hạch và PTNS hỗ trợ là 18,0 ± 7,2 hạch. Lượng máu mất trung bình của PTNS hoàn toàn 30,56 ± 10,2 ml và PTNS hỗ trợ 36,11 ± 9,9 ml. Thời gian phẫu thuật trung bình của nhóm PTNS hoàn toàn là 206,4 ± 30,6 phút và PTNS hỗ trợ 220 ± 40,9 phút. Tỷ lệ biến chứng sau mổ của nhóm PTNS hoàn toàn là 4,4% và PTNS hỗ trợ là 22,3%. Thời gian nằm viện trung bình của nhóm PTNS hoàn toàn là 7,5 ± 2,1 ngày và PTNS hỗ trợ là 10,2 ± 2,4 ngày. Kết luận: Phẫu thuật nội soi hoàn toàn và phẫu thuật nội soi hỗ trợ cắt toàn bộ dạ dày nạo vét hạch D2 do ung thư là kỹ thuật an toàn và hiệu quả trong điều trị ung thư dạ dày. ABSTRACT EVALUATION OF OUTCOMES TOTALLY LAPAROSCOPIC TOTAL GASTRECTOMY AND LAPAROSCOPIC - ASSISTED TOTAL GASTRECTOMY WITH D2 LYMPH NODE DISSECTION DUE TO CANCER Introduction: To evaluate the results of totally laparoscopic total gastrectomy (TLTG) and laparoscopicassisted total gastrectomy (LATG) with D2 lymph node dissection to treat gastric cancer in the Nghean General Friendship Hospital. Materials and Methods: In a retrospective cohort study, 126 patients with gastric cancer underwent TLTG and LATG with D2 lymph node dissection between 2013 and 2020. Results: There were 126 patients with an average age of 60.6 ± 11.1 years. The male/female ratio was 2.8/1. The percent of patients with tumors at stages I, II, III were 19.0%, 49.2%, 31.7%, 70.6% of patients had papillary adenocarcinoma and tubular adenocarcinoma. Patients with ring cell carcinoma wereaccounted for 24.6%. The total percent of incidents during the surgery of the group of TLTG was 4.4%, and the group of LATG was 20.6%. The average number of harvested lymph nodes in the group of TLTG was 23.7 ± 7.1, and the group of LATG was 18.0 ± 7.2. The average blood loss in the group of TLTG was 30.56 ± 10.2 ml, and the group of LATG was 36.11 ± 9.9 ml, and the average operation time in the group of TLTG was 206.4 ± 30.6 minutes, and the group of LATG was 220 ± 40.9 minutes. The total percent of postoperative complications in the group of TLTG was 4.4%, and the group of LATG was 22.3%. The hospital stays in the group of TLTG was 7.5 ± 2.1 days, and the group of LATG was 10.2 ± 2.4 days. Conclusions: TLTG and LATGwith D2 lymph node dissectionwere safe and effective in treating gastric cancer. Keywords: Laparoscopic gastrectomy, gastric cancer, total gastrectomy

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Kinh nghiệm qua 126 bệnh nhân phẫu thuật nội soi cắt toàn bộ dạ dày điều trị ung thư dạ dày

Journal of Clinical Medicine- Hue Central Hospital ◽

10.38103/jcmhch.2021.71.10 ◽

2021 ◽

Author(s):

Van Huong Nguyen

Keyword(s):

Gastric Cancer ◽

Lymph Nodes ◽

Total Gastrectomy ◽

Operative Time ◽

Laparoscopic Total Gastrectomy ◽

Oral Feeding ◽

Linear Stapler ◽

The Mean ◽

End To End ◽

Mean Time

TÓM TẮT Đặt vấn đề: Báo cáo kinh nghiệm về kỹ thuật phẫu thuật nội soi cắt toàn bộ dạ dày qua 126 bệnh nhân điều trị ung thư dạ dày tại Bệnh viện Hữu nghị Đa khoa Nghệ An. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả hồi cứu, các bệnh nhân được phẫu thuật nội soi cắt toàn bộ dạ từ 2014 đến 05/2021. Kết quả: Có 126 bệnh nhân, tuổi trung bình 60,6 ± 11,1 tuổi. 15,9% ung thư 1/3 trên dạ dày và 81,7% là 1/3 giữa. Ung thư ở giai đoạn I, II, III là 19,0%, 49,2%, 31,7%. 71,4% PTNS hoàn toàn cắt TBDD và nối lưu thông tiêu hóa bằng máy cắt nối thẳng. 3,2% trường hợp có tai biến trong mổ và 2,4% có biến chứng sau mổ, không có trường hợp nào tử vong. Số hạch nạo vét được trung bình 22,06 ± 7,6 hạch, lượng máu mất trung bình là 32,14 ± 10,4 ml, thời gian phẫu thuật trung bình là 210,4 ± 34,3 phút, thời gian nằm viện trung bình là 8,3 ± 2,5 ngày và thời gian sống thêm toàn bộ sau mổ trung bình là 36,9 ± 2,25 tháng. Kết luận: PTNS cắt TBDD là kỹ thuật an toàn và hiệu quả trong điều trị UTDD, nối thực quản hỗng tràng bằng máy cắt nối thẳng không cắt thực quản và hỗng tràng trước là kỹ thuật an toàn, tiết kiệm. Từ khóa: Kỹ thuật phẫu thuật nội soi dạ dày, ung thư dạ dày. ABSTRACT EXPERIENCE IN 126 PATIENTS OF LAPAROSCOPIC TOTAL GASTRECTOMY FOR THE TREATMENT OF GASTRIC CANCER Background: The goal of this study was to report on the experience of laparoscopic total gastrectomy (LTG) in 126 patients with gastric cancer Materials and Methods: Retrospective descriptive study of 126 patients who underwent LTG for gastric cancer between 2014 and May 2021. Results: Mean age 60,6 ± 11,1; gastric cancer at stage I, II, III was 19,0%, 49,2%, 31,7% respectively. 71,4% patients underwent totally LTG and functional end-to-end esophagojejunostomy by linear stapler without previous resection of esophagus and jejunum. 3.2% of cases had complications during surgery and 2,4% of cases had complications after surgery. There was no postoperative deaths. The average number of dredged lymph nodes was 22.06 ± 7.6 lymph nodes. The mean blood loss was 32.14 ± 10.4 ml. The mean operative time was 210.4 ± 34.3 minutes. The mean time for beginning oral feeding was 4.4 ± 1.9 days. The mean hospital stay was 8.3 ± 2.5 days. The mean overall survival was 36.9 ± 2,25 months. Conclusions: LTG is a safe and effective technique for the treatment of gastric cancer. The technique functional end-to-end esophagojejunostomy by linear stapler without previous resection of esophagus and jejunum was safe and saving. Keywords: Technique of laparoscopic gastrectomy, gastric cancer

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Totally Laparoscopic Total Gastrectomy for Gastric Cancer at a Single Institutional Experience and Changes in Technique of Esophagojejunostomy

Indian Journal of Surgery ◽

10.1007/s12262-016-1471-4 ◽

2016 ◽

Vol 78 (3) ◽

pp. 249-253 ◽

Cited By ~ 1

Author(s):

Akira Umemura ◽

Keisuke Koeda ◽

Hisataka Fujiwara ◽

Takehiro Chiba ◽

Koki Otsuka ◽

...

Keyword(s):

Gastric Cancer ◽

Total Gastrectomy ◽

Laparoscopic Total Gastrectomy ◽

Institutional Experience ◽

Totally Laparoscopic Total Gastrectomy ◽

Totally Laparoscopic

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Intelligent Algorithm-Based Magnetic Resonance Imaging in Radical Gastrectomy under Laparoscope

Contrast Media & Molecular Imaging ◽

10.1155/2021/1701447 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Wenkui Mo ◽

Cansong Zhao

Keyword(s):

Gastric Cancer ◽

Operation Time ◽

Laparoscopic Group ◽

Postoperative Hospital Stay ◽

Intraoperative Blood Loss ◽

Resonance Imaging ◽

Intelligent Algorithm ◽

Short Term ◽

Laparoscopy Group ◽

Significant Difference

The study focused on the influence of intelligent algorithm-based magnetic resonance imaging (MRI) on short-term curative effects of laparoscopic radical gastrectomy for gastric cancer. A convolutional neural network- (CNN-) based algorithm was used to segment MRI images of patients with gastric cancer, and 158 subjects admitted at hospital were selected as research subjects and randomly divided into the 3D laparoscopy group and 2D laparoscopy group, with 79 cases in each group. The two groups were compared for operation time, intraoperative blood loss, number of dissected lymph nodes, exhaust time, time to get out of bed, postoperative hospital stay, and postoperative complications. The results showed that the CNN-based algorithm had high accuracy with clear contours. The similarity coefficient (DSC) was 0.89, the sensitivity was 0.93, and the average time to process an image was 1.1 min. The 3D laparoscopic group had shorter operation time (86.3 ± 21.0 min vs. 98 ± 23.3 min) and less intraoperative blood loss (200 ± 27.6 mL vs. 209 ± 29.8 mL) than the 2D laparoscopic group, and the difference was statistically significant ( P < 0.05 ). The number of dissected lymph nodes was 38.4 ± 8.5 in the 3D group and 36.1 ± 6.0 in the 2D group, showing no statistically significant difference ( P > 0.05 ). At the same time, no statistically significant difference was noted in postoperative exhaust time, time to get out of bed, postoperative hospital stay, and the incidence of complications ( P > 0.05 ). It was concluded that the algorithm in this study can accurately segment the target area, providing a basis for the preoperative examination of gastric cancer, and that 3D laparoscopic surgery can shorten the operation time and reduce intraoperative bleeding, while achieving similar short-term curative effects to 2D laparoscopy.

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