The Safety and Efficacy of Total Laparoscopic Distal Gastrectomy With Delta-Shaped Anastomosis Compared With Laparoscopic-Assisted Distal Gastrectomy

Aim: To evaluate the safety and short-time benefits of enhanced recovery after surgery on hospital stay, recovery of gastrointestinal function and complications after total laparoscopic distal gastrectomy (TLDG) with delta-shaped anastomosis, comparing with laparoscopic-assisted distal gastrectomy (LADG). Methods: A retrospective analysis was performed in 134 patients with gastric cancer who were treated at Wuhan General Hospital of Guangzhou Military Area Command from November 2013 to August 2015. A total of 70 patients underwent TLDG, and 64 patients underwent LADG. All patients were performed elective standard D2 total gastrectomy by 1 group of experienced surgeons. The short-term therapeutic benefits, including duration of flatus and defecation, postoperative pain, duration of postoperative stay, and complications between the 2 groups were analyzed. Results: Compared with LADG, TLDG had shorter time to the first flatus (74.09 ± 11.08 hours versus 84.11 ± 12.18 hours, P < 0.001), earlier postoperative liquid diet intake (98.83 ± 10.63 hours versus 108.58 ± 13.08 hours, P < 0.001), less dosage of pain killers (2.01 ± 0.85 versus 2.41 ± 0.85, P = 0.009), faster recovery with a shorter postoperative hospital stay (8.14 ± 0.3.43 days versus 9.97 ± 4.53 days, P = 0.009), There were no significant difference in operation time, blood loss, the number of lymph nodes retrieved, or the incidence of postoperative complications (anastomotic bleeding or leakage, wound infection, digestive tract dysfunction, thrombosis, or death; P > 0.05). Conclusions: TLDG with delta-shaped anastomosis is a safe and effective fast-tract surgical approach for earlier gastric cancer, which would probably achieve the short-term curative effect. Further studies based on larger volumes and long-term effects are required to confirm these findings.

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The Safety and Efficacy of Total Laparoscopic Distal Gastrectomy With Delta-Shaped Anastomosis Compared With Laparoscopic-Assisted Distal Gastrectomy

International Surgery ◽

10.9738/intsurg-d-19-00014.1 ◽

2020 ◽

Vol 104 (3-4) ◽

pp. 131-137

Author(s):

Y. B. Gao ◽

W. D. Jin ◽

J. Cao ◽

Z. Y. Zhang ◽

X. Cai ◽

...

Keyword(s):

Gastric Cancer ◽

Hospital Stay ◽

Distal Gastrectomy ◽

Enhanced Recovery ◽

Operation Time ◽

Laparoscopic Distal Gastrectomy ◽

Short Term ◽

Therapeutic Benefits ◽

Significant Difference ◽

Laparoscopic Assisted

Aim: To evaluate the safety and short-time benefits of enhanced recovery after surgery on hospital stay, recovery of gastrointestinal function and complications after total laparoscopic distal gastrectomy (TLDG) with delta-shaped anastomosis, comparing with laparoscopic-assisted distal gastrectomy (LADG). Methods: A retrospective analysis was performed in 134 patients with gastric cancer who were treated at Wuhan General Hospital of Guangzhou Military Area Command from November 2013 to August 2015. A total of 70 patients underwent TLDG, and 64 patients underwent LADG. All patients were performed elective standard D2 total gastrectomy by 1 group of experienced surgeons. The short-term therapeutic benefits, including duration of flatus and defecation, postoperative pain, duration of postoperative stay, and complications between the 2 groups were analyzed. Results: Compared with LADG, TLDG had shorter time to the first flatus (74.09 ± 11.08 h versus 84.11 ± 12.18 h, P < 0.001), earlier postoperative liquid diet intake (98.83 ± 10.63 h versus 108.58 ± 13.08 h, P < 0.001), less dosage of pain killers (2.01 ± 0.85 versus 2.41 ± 0.85, P = 0.009), faster recovery with a shorter postoperative hospital stay (8.14 ± 0.3.43 d versus 9.97 ± 4.53 d, P = 0.009), There were no significant difference in operation time, blood loss, the number of lymph nodes retrieved, or the incidence of postoperative complications (anastomotic bleeding or leakage, wound infection, digestive tract dysfunction, thrombosis, or death; P > 0.05). Conclusions: TLDG with delta-shaped anastomosis is a safe and effective fast-tract surgical approach for earlier gastric cancer, which would probably achieve the short-term curative effect. Further studies based on larger volumes and long-term effects are required to confirm these findings.

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Robotic versus laparoscopic distal gastrectomy in patients with gastric cancer: a propensity score-matched analysis

BMC Surgery ◽

10.1186/s12893-021-01212-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Taro Isobe ◽

Naotaka Murakami ◽

Taizan Minami ◽

Yuya Tanaka ◽

Hideaki Kaku ◽

...

Keyword(s):

Gastric Cancer ◽

Propensity Score ◽

Hospital Stay ◽

Surgical Outcomes ◽

Distal Gastrectomy ◽

Length Of Hospital Stay ◽

Operation Time ◽

Laparoscopic Distal Gastrectomy ◽

Safe Procedure ◽

Clinical Advantage

Abstract Background Robotic distal gastrectomy (RDG) has been increasingly used for the treatment of gastric cancer (GC). However, whether RDG has a clinical advantage over laparoscopic distal gastrectomy (LDG) is yet to be determined. Thus, this study aimed to assess the feasibility and safety of RDG for the treatment of GC as compared with LDG. Methods In total, 157 patients were enrolled between February 2018 and August 2020 in this retrospective study. We then compared the surgical outcomes between RDG and LDG using propensity score-matching (PSM) analysis to reduce the confounding differences. Results After PSM, a clinicopathologically well-balanced cohort of 100 patients (50 in each group) was analyzed. The operation time for the RDG group (350.1 ± 58.1 min) was determined to be significantly longer than that for the LDG group (257.5 ± 63.7 min; P < 0.0001). Of interest, there was a decreased incidence of pancreatic fistulas and severe complications after RDG as compared with LDG (P = 0.092 and P = 0.061, respectively). In addition, postoperative hospital stay was statistically slightly shorter in the RDG group as compared with the LDG group (12.0 ± 5.6 vs. 13.0 ± 12.3 days; P = 0.038). Conclusions Our study confirmed that RDG is a feasible and safe procedure for GC in terms of short-term surgical outcomes. A surgical robot might reduce postoperative severe complications and length of hospital stay.

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Reduced-port laparoscopic distal gastrectomy in obese gastric cancer patients

PLoS ONE ◽

10.1371/journal.pone.0255855 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0255855

Author(s):

Dong Yeon Kang ◽

Ho Goon Kim ◽

Dong Yi Kim

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Surgical Outcomes ◽

Distal Gastrectomy ◽

Laparoscopic Distal Gastrectomy ◽

Obese Patients ◽

Short Term ◽

Significant Difference ◽

Reduced Port ◽

Gastric Cancer Patients

Background Reduced-port laparoscopic gastrectomy is currently widely performed for patients with gastric cancer. However, its safety in obese patients has not yet been verified. This is the first study on reduced-port laparoscopic distal gastrectomy (RpLDG) in obese patients with gastric cancer. This study aimed to evaluate the short-term surgical outcomes and investigate the feasibility and safety of RpLDG in obese patients with gastric carcinoma. Material and methods A total of 271 gastric cancer patients who underwent RpLDG at our institution were divided into two groups: non-obese [body mass index (BMI) <30 kg/m2, n = 251; NOG] and obese (BMI ≥30 kg/m2, n = 20; OG). The mean age of the enrolled patients was 64.8 ± 11.4 years, with 72.0% being men and 28.0% women. Operative details and short-term surgical outcomes, including hospital course and postoperative complications, were compared by retrospectively reviewing the medical records. Results No significant difference in operation time was found between the NOG and OG (205.9 ± 40.0 vs. 211.3 ± 37.3 minutes, P = 0.563). Other operative outcomes in the OG, including estimated blood loss (54.1 ± 86.1 vs. 54.0 ± 39.0 mL, P = 0.995) and retrieved lymph nodes (36.2 ± 16.4 vs. 35.5 ± 18.2, P = 0.875), were not inferior to those in the NOG. There were also no statistical differences in short-term surgical outcomes, including the incidence of surgical complications (13.9% vs. 10.0%, P = 1). Conclusion RpLDG can be performed safely in obese gastric cancer patients by an experienced surgeon. It should be considered a feasible alternative to conventional port distal gastrectomy.

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COMPARISON OF SHORT TERM OUTCOMES FOLLOWING TOTALLY LAPAROSCOPIC AND LAPAROSCOPIC ASSISTED DISTAL GASTRECTOMY FOR GASTRIC CANCER

10.26226/morressier.57c5383bd462b80296c9c4a0 ◽

2016 ◽

Author(s):

Sung Don Oh

Keyword(s):

Gastric Cancer ◽

Distal Gastrectomy ◽

Short Term ◽

Laparoscopic Assisted ◽

Totally Laparoscopic

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ASO Author Reflections: Multimodal Enhanced Recovery After Surgery (ERAS) Program in Totally Laparoscopic Distal Gastrectomy for Gastric Cancer: What Have We Learned?

Annals of Surgical Oncology ◽

10.1245/s10434-018-6848-0 ◽

2018 ◽

Vol 25 (S3) ◽

pp. 727-728

Author(s):

So Hyun Kang ◽

Young Suk Park ◽

Do Joong Park ◽

Hyung-Ho Kim ◽

Sang-Hoon Ahn

Keyword(s):

Gastric Cancer ◽

Distal Gastrectomy ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Laparoscopic Distal Gastrectomy ◽

Totally Laparoscopic Distal 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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