Laparoscopic total gastrectomy as a valid procedure to treat gastric cancer option both in early and advanced stage: A systematic review and meta-analysis

Publication date: Available online 23 August 2019Source: European Journal of Surgical OncologyAuthor(s): Youjin Oh, Min Seo Kim, Yoon Teak Lee, Chang Min Lee, Jong Han Kim, Sungsoo ParkAbstractAlthough laparoscopic total gastrectomy (LTG) compared to open total gastrectomy (OTG) has been widely used for advanced gastric cancer patients, its oncologic validity is yet to be proven. We performed systemic review and meta-analysis to compare LTG versus OTG for early and advanced stages of gastric cancer. Short- and long-term outcomes of both procedures were analyzed using original studies collected by searching Google Scholar, Medline, PubMed, Embase, and Cochrane library in accordance with the PRISMA guidelines. To analyze procedures more precisely, we categorized studies into advanced gastric cancer (AGC) and early gastric cancer (EGC) groups and matched lymph node (LN) dissection, and metastasis ratio. Nineteen studies with a total of 3943 patients were included. LTG required more operative time and had less dissected LNs, indicating a favorable quality of OTG. However, LTG was superior with less blood loss, a shorter postoperative hospital stay, and lower postoperative complication rates. The 5-year survival rate was similar in both groups in which extent of LN dissection and lymph node metastasis ratio were controlled. Although more LNs were removed in OTG, the discrepancy had an insignificant impact on the survival rate. To the best of our knowledge, this study is the first ...
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research

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AbstractRobotic gastrectomy (RG) using the da Vinci Surgical System for gastric cancer was approved for national medical insurance coverage in Japan in April, 2018, and has been used increasingly since. We reviewed the current evidence on RG, open gastrectomy (OG), and conventional laparoscopic gastrectomy (LG) to identify differences in surgical outcomes between Japan and other countries. Briefly, three independent reviewers systematically reviewed the data collected from a comprehensive literature search by an independent organization and focused on the following nine endpoints: mortality, morbidity, operative time, esti...
Source: Surgery Today - Category: Surgery Source Type: research
Egemen Cicek, Fatih Sumer, Ersin Gundogan, Cihan Gokler, Cuneyt KayaalpJournal of Minimal Access Surgery 2019 15(4):348-350Laparoscopic surgery for remnant gastric cancer has been reported in a limited number of cases, and data on post-operative complications are lacking. A 58-year-old male was admitted with remnant gastric cancer. He had undergone open subtotal gastrectomy 9 years ago for gastric cancer. Laparoscopic total gastrectomy was performed, and he was discharged on the 10th day uneventfully. The patient had complained of nausea and vomiting in the 2nd post-operative month. He clinically and radiologically diagnos...
Source: Journal of Minimal Access Surgery - Category: Surgery Authors: Source Type: research
ConclusionsOur multicenter dataset analysis indicated that the prognosis of patients with gastric cancer migration from clinical stage I to pathological stage II or III was independent of the surgical approach.
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
Abstract Background. We compared the outcomes of laparoscopic-assisted (LA) and robotic-assisted (RA) gastrectomies performed for gastric adenocarcinoma in the National Cancer Database. Methods. The National Cancer Database was queried for patients 18 years old with stages I to III gastric adenocarcinoma who underwent LA or RA gastrectomy. Propensity matching was performed between the 2 groups with regard to clinical staging, adjuvant treatment, demographics, and the extent of surgery. Results. A cohort of 1893 (1262 = LA, 631 = RA) patients was identified in a 2:1 propensity matching. The groups were well matched...
Source: Surgical Innovation - Category: Surgery Authors: Tags: Surg Innov Source Type: research
CONCLUSIONS: The superiority of laparoscopic gastrectomy towards the open technique is widely accepted, yet the proven acceptance of minimally invasive robotic techniques is still debated and not scientifically established. Technical challenges are the main point of discussion among the experts on the field, as well as the advantages of laparoscopic and robotic assisted gastrectomy over the conventional open. This review provides a comparison on technical aspects, the short and long term outcomes of open and minimally invasive gastrectomy with D2 lymphadenectomy in early and advanced gastric cancer. PMID: 31424638 [PubMed - in process]
Source: Journal of B.U.ON. - Category: Cancer & Oncology Tags: J BUON Source Type: research
CONCLUSION: Although a technically demanding and time-consuming procedure, LGD2 offers the advantages of minimal invasion and can achieve the same degree of radical resections, harvested lymph nodes and short- or long-term prognosis for the treatment of locally AGC. PMID: 31424636 [PubMed - in process]
Source: Journal of B.U.ON. - Category: Cancer & Oncology Tags: J BUON Source Type: research
In gastrectomy, postoperative elevation of C-reactive protein (CRP) is thought to be useful for predicting complications. Laparoscopic gastrectomy (LG) is less invasive than laparotomy and the elevation of CRP...
Source: BMC Surgery - Category: Surgery Authors: Tags: Research article Source Type: research
The number of patients who are undergoing laparoscopic gastrectomy for treating gastric cancer is increasing. Although prophylactic drains have been widely employed following the procedure, there are few studi...
Source: World Journal of Surgical Oncology - Category: Cancer & Oncology Authors: Tags: Research Source Type: research
CONCLUSIONS: We believe that this laparoscopic suprapancreatic lymphadenectomy using SME takes advantage of the surgical anatomy and achieves en bloc removal of the primary tumor and gastric mesentery. This series is a proof of concept that this procedure can be performed in a timely manner and is feasible. PMID: 31407184 [PubMed - as supplied by publisher]
Source: Methods of Information in Medicine - Category: Information Technology Authors: Tags: Ann Surg Oncol Source Type: research
This study investigated the clinical characteristics and proper management of internal hernia after gastrectomy.MethodsFrom June 2001 to June 2016, patients who underwent gastrectomy, either open or laparoscopic (robotic) surgery, with potential internal hernia defect were enrolled. The hernia defect was not closed in any of the enrolled patients. The clinicopathological data of internal hernia patients were compared to patients without internal hernia to identify risk factors. Surgical outcomes of internal hernia were compared between patients who underwent early and late intervention group according to time interval from...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
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