Feasibility of laparoscopic gastrectomy for patients with poor physical status: a retrospective cohort study based on a nationwide registry database in Japan

AbstractBackgroundLaparoscopic gastrectomy (LG) is an established minimally invasive procedure for gastric cancer. However, it is controversial whether LG is useful for patients with poor physical status classified into higher classes of the American Society of Anesthesiologists physical status (ASA-PS) classification. The aim of this study was to determine the feasibility of LG in patients with ASA-PS class  ≥ 3.MethodsWe extracted data for a total of 28,160 patients with an ASA-PS class  ≥ 3 who underwent distal or total gastrectomy for gastric cancer between January 2013 and December 2017 from the National Clinical Database Japan society for gastroenterological surgery registry. We developed a propensity score model from baseline demographics and comorbidities and matched pa tients undergoing LG to those undergoing open gastrectomy (OG) using a 1:1 ratio. Mortality and morbidities (within 30 days and in-hospital) were compared between the 6998 matched patient pairs.ResultsIn-hospital mortality was significantly lower in patients undergoing LG than in those undergoing OG (2.3% vs. 3.0%,p = 0.01), while the 30-day mortality was similar (1.6% vs. 1.5%). The length of hospital stay was significantly shorter in the LG group (median, 14 days vs. 17 days,p 
Source: Gastric Cancer - Category: Gastroenterology Source Type: research

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AbstractBackgroundLaparoscopic gastrectomy is becoming more commonly performed, but acquisition of its technique remains challenging. We investigated whether laparoscopy-assisted distal gastrectomy (LDG) performed by trainees (TR) supervised by a technically qualified experienced surgeon (QS) is feasible and safe.MethodsThe short-term outcomes of LDG were assessed in patients with gastric cancer between 2008 and 2018. We compared patients who underwent LDG performed by qualified experienced surgeons (QS group) with patients who underwent LDG performed by the trainees (TR group).ResultsThe operation time was longer in the T...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Conclusions: In addition to being technically feasible for treatment of AGC in terms of morbidity, LG with D2 LND for locally advanced gastric cancer showed acceptable 3-year DFS outcomes. Trial Registration: ClinicalTrials.gov Identifier: NCT01441336. PMID: 30944763 [PubMed]
Source: Journal of Gastric Cancer - Category: Gastroenterology Tags: J Gastric Cancer Source Type: research
ConclusionsThis study represents the first prospective feasibility evaluation of sentinel lymph node sampling for early gastric cancer in North America with promising preliminary results. The dual tracer method was superior to single agent blue dye in identifying sentinel nodal basins. Considerable further study is necessary to verify the safety and utility of SLN mapping in North American patients with early gastric adenocarcinoma.
Source: Journal of Gastrointestinal Surgery - Category: Surgery Source Type: research
This study aimed to compare outcomes following laparoscopic versus open gastrectomy for advanced gastric cancer at a regional institution in Hong Kong. METHODS: Fifty-four patients who underwent laparoscopic gastrectomy from January 2009 to March 2017 were compared with 167 patients who underwent open gastrectomy during the same period. All had clinical T2 to T4 lesions and underwent curative-intent surgery. The two groups were matched for age, sex, American Society of Anaesthesiologists class, tumour location, morphology, and clinical stage. The endpoints were perioperative and long-term outcomes including survival a...
Source: Hong Kong Med J - Category: General Medicine Authors: Tags: Hong Kong Med J Source Type: research
Publication date: Available online 11 January 2019Source: European Journal of Integrative MedicineAuthor(s): Shuhan Gu, Hebin Lang, Jianhui Gan, Zhiwen Zheng, Fang Zhao, Qing TuAbstractIntroductionAcupuncture is widely used as perioperative analgesia and promotes postoperative physical recovery. Transcutaneous electrical acupoint stimulation (TEAS) is a kind of acupuncture method that has many advantages. However, there has been little study on application of TEAS in laparoscopic radical gastrectomy. This is a study exploring the effects of TEAS on gastrointestinal function recovery after laparoscopic radical gastrectomy t...
Source: European Journal of Integrative Medicine - Category: Complementary Medicine Source Type: research
Purpose: The purpose of this study was to compare the short- and long-term outcomes after laparoscopic total gastrectomy (LTG) between elderly and non-elderly patients with gastric cancer.Methods: A retrospective analysis was performed using clinical and follow-up data from 168 patients treated with LTG for gastric cancer at our institution from January 2010 to December 2017. For this study, the short- and long-term outcomes (including tumor recurrence rate, disease-free survival rate, and overall survival rate) were compared between the elderly group (≥70 years) and non-elderly group (
Source: Journal of Cancer - Category: Cancer & Oncology Authors: Tags: Research Paper Source Type: research
ConclusionsThe study results suggest that RPG for gastric cancer by an experienced surgeon is a feasible and safe technique. The RPG procedure can be presented to patients as one of the effective treatment options.
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSIONS: The study results suggest that RPG for gastric cancer by an experienced surgeon is a feasible and safe technique. The RPG procedure can be presented to patients as one of the effective treatment options. PMID: 30178393 [PubMed - as supplied by publisher]
Source: Ann Oncol - Category: Cancer & Oncology Authors: Tags: Ann Surg Oncol Source Type: research
DiscussionPrevious studies have demonstrated the safety and feasibility of D2  + CME for locally advanced gastric cancer; however, there is still a lack of evidence to support its therapeutic effect. Thus, we performed this randomized trial to investigate whether D2 + CME can improve oncologic outcomes of patients with locally advanced gastric cancer. The findings fro m this trial may potentially optimize the surgical procedure and may improve the prognosis of patients with locally advanced gastric cancer.Trial registrationClinicalTrials.gov,NCT01978444. Registered on October 31, 2013.
Source: Trials - Category: Research Source Type: clinical trials
Conclusions: Laparoscopic gastrectomy can be safely performed in very elderly patients with gastric cancer who have outlived the average lifespan of the Korean population. However, impact of laparoscopic gastrectomy on improving survival is not clear, and careful patient selection is recommended. PMID: 29984061 [PubMed]
Source: Journal of Gastric Cancer - Category: Gastroenterology Tags: J Gastric Cancer Source Type: research
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