Laparoscopic Gastrectomy for Advanced Gastric Cancer

Autor: Kazuyoshi Yamamoto, Takeshi Omori, Yukinori Kurokawa, Atsushi Takeno, Yusuke Akamaru, Koichi Demura, Kazuyuki Okada, Kentaro Kishi, Takuro Saito, Tsuyoshi Takahashi, Hidetoshi Eguchi, Yuichiro Doki
Rok vydání: 2023
Předmět:
Zdroj: The American Surgeon™. :000313482211140
ISSN: 1555-9823
0003-1348
DOI: 10.1177/00031348221114042
Popis: Background Application of laparoscopic gastrectomy (LG) to advanced gastric cancer is still controversial due to lack of sufficient surgical and oncological outcomes. The purpose of this study was to elucidate the feasibility of LG for advanced gastric cancer by multicenter prospective cohort study. Methods A total of 98 patients with clinical stage II or III gastric cancer from 8 institutes were analyzed in this study. The primary endpoint was incidence of severe postoperative complications of Clavien-Dindo classification grade Ⅲa or higher. Results Sixty-six patients underwent laparoscopic distal gastrectomy (LDG), 10 patients laparoscopic proximal gastrectomy (LPG), 21 patients laparoscopic total gastrectomy (LTG), and 1 patient received gastro-jejunostomy. Seven patients had positive lavage cytology (CY1) and R0 rate was 90.8%. Three patients (3.1%) required conversion to open surgery. The incidence of overall postoperative complications and severe postoperative complications were 17.3% and 9.2%, respectively, those were comparable to the data of open surgery for advanced gastric cancer previously published. By surgical procedure, the incidence of severe postoperative complications of LDG, LPG, and LTG were 4.6, 0, and 28.6% and the rate of severe anastomotic leakage of LDG, LPG, and LTG were 0, 0, and 9.5%, respectively. Total gastrectomy was an only independent risk factor of severe postoperative complications in LG for advanced gastric cancer (odds ratio 8.75; 95% confidence interval 1.70-56.69, P = .0092). Discussion The incidence of severe postoperative complications after LG performed by qualified surgeons was acceptable even in cases of advanced gastric cancer; however, careful attention is required to adopt LTG. (UMIN000025733).
Databáze: OpenAIRE
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