Safety of laparoscopic radical gastrectomy in gastric cancer patients with liver cirrhosis.

Autor: Kim DJ; Department of Surgery, College of Medicine, The Catholic University of Korea, #327 Sosaro, Won-mi Gu, Bucheon, Gyeonggido, Republic of Korea., Park CH; Department of Surgery, College of Medicine, The Catholic University of Korea, #327 Sosaro, Won-mi Gu, Bucheon, Gyeonggido, Republic of Korea., Kim W; Department of Surgery, College of Medicine, The Catholic University of Korea, #327 Sosaro, Won-mi Gu, Bucheon, Gyeonggido, Republic of Korea., Jin HM; Department of Surgery, College of Medicine, The Catholic University of Korea, #327 Sosaro, Won-mi Gu, Bucheon, Gyeonggido, Republic of Korea., Kim JJ; Department of Surgery, College of Medicine, The Catholic University of Korea, #327 Sosaro, Won-mi Gu, Bucheon, Gyeonggido, Republic of Korea., Lee HH; Department of Surgery, College of Medicine, The Catholic University of Korea, #327 Sosaro, Won-mi Gu, Bucheon, Gyeonggido, Republic of Korea., Lee JH; Department of Surgery, College of Medicine, The Catholic University of Korea, #327 Sosaro, Won-mi Gu, Bucheon, Gyeonggido, Republic of Korea. surgeryjun@catholic.ac.kr.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2017 Oct; Vol. 31 (10), pp. 3898-3904. Date of Electronic Publication: 2017 Feb 15.
DOI: 10.1007/s00464-017-5420-5
Abstrakt: Background: Laparoscopic gastrectomy (LG) in gastric cancer patients with liver cirrhosis (LC) has rarely been reported. In this study, we aimed to elucidate the feasibility of LG compared with that of open gastrectomy (OG) for LC patients.
Methods: Of the 75 LC patients who underwent radical gastrectomy for gastric cancer between April 2005 and March 2014, 36 patients who underwent LG were compared with 39 patients who underwent OG. Comparisons were based on clinicopathologic characteristics, surgical outcomes, and long-term survival rates.
Results: Comparison of LG and OG revealed no significant differences in the clinicopathologic characteristics. Five patients in the LG group and eight in the OG group showed a Child-Turcotte-Pugh score (CTPs) over A. In surgical outcomes, we observed shorter operation times (191.4 ± 63.9 vs. 225.9 ± 77.1 min, p = 0.039), reduced estimated blood loss (175.5 ± 214.1 vs. 396.9 ± 514.8 ml, p = 0.021), and shorter hospital stays (10.4 ± 4.6 vs. 13.7 ± 5.8 days, p = 0.008) in LG than OG. Regarding postoperative morbidity, 7 (19.4%) and 10 (25.6%) complications were observed in the LG and OG groups, respectively. There was no difference in complications between the two groups regardless of the CTPs. One patient with a CTPs of C succumbed to hepatic failure following LG. Long-term survival and overall and recurrence-free survival rates did not differ between the two groups.
Conclusions: Even in cases with CTPs B, LG with lymph node dissection for gastric cancer patient was safer and acceptable than OG was. Therefore, LG can be considered an alternative surgical approach in gastric cancer with LC.
Databáze: MEDLINE
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