Short-Term Results of Near-Total (95%) Laparoscopic Gastrectomy

Conclusions95% gastrectomy allows selected patients to meet the oncological standards of resection in proximal gastric cancer in a reproducible and safe manner, reducing perioperative risks such as anastomotic leakage. It is a non-comparative observational prospective study, so more studies are needed to assess the standardization of the technique.ResumenIntroducciónLa gastrectomía total es una cirugía con importante morbimortalidad perioperatoria que es considerada el tratamiento de elección en el cáncer gástrico proximal. Descrita por primera vez en 1980, nuestro grupo describió y estandarizó la gastrectomía 95% totalmente laparoscópica en 2014. Esta técnica pretende disminuir las complicaciones de la gastrectomía total sin descuidar la radicalidad oncológica de la misma. Se presentan los primeros resultados de una cohorte de casos consecutivos tras 4 años realizando la técnica en 2 centros hospitalarios.MétodosSe ha llevado a cabo un estudio prospectivo observacional en 67 pacientes con gastrectomía 95% laparoscópica realizadas entre 2014 y 2017. El objetivo principal ha sido la detección de complicaciones (Clavien Dindo > IIIa), centrándose en la fuga anastomótica como la más importante. Objetivo secundario fue valorar la calidad de la cirugía oncológica.ResultadosSe incluyeron 67 pacientes con...
Source: Cirugia Espanola - Category: Surgery Source Type: research

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AbstractBackgroundCompletion total gastrectomy with radical lymphadenectomy for remnant gastric cancer is a technically demanding procedure. No previous studies have compared laparoscopic to robotic-assisted completion gastrectomy, whereas a few small case series have reported benefits of minimally invasive surgery over open surgery. The aim of this study is to assess the effectiveness and feasibility of robotic-assisted compared with laparoscopic completion gastrectomy for the treatment of remnant gastric cancer.MethodsWe retrospectively reviewed data from 55 patients who underwent minimally invasive completion gastrectom...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Hua Qiu, Jun-Hua Ai, Jun Shi, Ren-Feng Shan, Dong-Jun YuJournal of Cancer Research and Therapeutics 2019 15(7):1450-1463 Gastrectomy is considered the gold standard treatment for gastric cancer patients. Currently, there are two minimally invasive surgical methods to choose from, robotic gastrectomy (RG) and laparoscopic gastrectomy (LG). Nevertheless, it is still unclear which is superior between the two. This meta-analysis aimed to investigate the effectiveness and safety of RG and LG for gastric cancer. A systematic literature search was performed using PubMed, Embase, and the Cochrane Library databases until September...
Source: Journal of Cancer Research and Therapeutics - Category: Cancer & Oncology Authors: Source Type: research
ConclusionsE-stasis after LPPG occurs in 7.6% of patients. Age, DM, and intraabdominal infection are significantly related to E-stasis. E-stasis is associated with poorer nutritional and functional outcomes even at 1  year postoperatively.
Source: Gastric Cancer - Category: Gastroenterology Source Type: research
Conclusions: Postoperative morbidity, including SSI rates, did not significantly increase in patients undergoing TLDG without prophylactic antibiotic use. A large prospective randomized trial is warranted to reappraise the efficacy of prophylactic antibiotic use in patients undergoing TLDG. PMID: 31897347 [PubMed]
Source: Journal of Gastric Cancer - Category: Gastroenterology Tags: J Gastric Cancer Source Type: research
This study compared the feasibility of LSGD in patients undergoing TRDG and TLDG. Materials and Methods All c: onsecutive patients who underwent LSGD after distal gastrectomy for gastric cancer between January 2009 and December 2017 were analyzed retrospectively. Propensity score matching (PSM) analysis was performed to reduce the selection bias between TRDG and TLDG. Short-term outcomes, functional outcomes, learning curve, and risk factors for postoperative complications were analyzed. Results: This analysis included 414 patients, of whom 275 underwent laparoscopy and 139 underwent robotic surgery. PSM analysis s...
Source: Journal of Gastric Cancer - Category: Gastroenterology Tags: J Gastric Cancer Source Type: research
ConclusionA laparoscopic subtotal gastrectomy with D2+CME procedure provides for a complete and standardized en bloc excision of the suprapancreatic area dissection.
Source: Journal of Gastrointestinal Surgery - Category: Surgery Source Type: research
ConclusionsESD after laparoscopic distal gastrectomy is largely safe in terms of short-term surgical outcomes, but a short interval between the two procedures and a large ESD scar can make subsequent operation difficult.
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: TLDG with B-I or B-II anastomosis is safe and feasible for gastric cancer. B-II anastomosis may require less time than B-I anastomosis.
Source: Journal of Minimal Access Surgery - Category: Surgery Authors: Source Type: research
Conclusion: Laparoscopic radical gastrectomy is superior to open surgery in the aspects of intra-operative blood loss, post-operative exhaust time, post-operative hospital stay and timing of drain removal. With the number of laparoscopic radical gastrectomy cases increased, the duration of surgery is shortened and the amount of intra-operative blood loss will decrease.
Source: Journal of Minimal Access Surgery - Category: Surgery Authors: Source Type: research
ConclusionCareful evaluation of the clinical findings and close observation with EGD can help detect mucosal demarcation lines and ascertain the perfect timing for intervention in cases with suspected ischemia. Although gastric remnant ischemia requires emergency treatment, laparoscopic management is a feasible option when performed by an expert surgeon.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
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