Outcomes of minimally invasive surgery for early gastric cancer are comparable with those for open surgery: analysis of 1,013 minimally ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-11-22

AUTHORS

Seung-Young Oh, Sebastianus Kwon, Kyung-Goo Lee, Yun-Suhk Suh, Hwi-Nyeong Choe, Seong-Ho Kong, Hyuk-Joon Lee, Woo Ho Kim, Han-Kwang Yang

ABSTRACT

Background This study aimed to compare the short- and long-term results of minimally invasive surgery (MIS) and open surgery for primary early gastric cancer (EGC) at a single high-volume institution.MethodsThe clinicopathologic and survival data of primary gastric cancer patients who underwent a minimally invasive radical gastrectomy at Seoul National University Hospital from December 2003 to January 2012 were retrospectively analyzed. For comparison of short-term outcomes, the data for 1,112 patients who underwent a radical open gastrectomy from 2007 to 2011 were collected. For long-term outcome analysis, the data for 962 patients who underwent a radical open gastrectomy from 2004 to 2006 were collected. Because the application of MIS was limited to suspected EGC, the control groups were similarly limited to patients deemed to have EGC as shown by preoperative endoscopy, endoscopic ultrasound, or both.ResultsThe review of our database identified 1,013 patients who had undergone MIS for gastric cancer. In the short-term outcome analysis, the MIS group showed statistically better results than the open surgery group in terms of postoperative hospital stay (8.7 vs. 11.3 days; p < 0.001), estimated blood loss (75.4 vs. 142.3 ml; p < 0.001), and overall complication rate (17.5 vs. 24.4 %; p < 0.001). In the subset analysis of total gastrectomy, the local complication rate was much higher in the MIS group than in the open surgery group. Both uni- and multivariate analyses showed that not only the surgical approach but also age, chronic liver disease, chronic renal disease, and additional organ resection had significant effects on complications. In the long-term outcome analysis, the two groups showed comparable disease-free survival rates.ConclusionsThe use of MIS for EGC showed a shorter operation time, a shorter postoperative hospital stay, and a lower overall complication rate than open surgery but a comparable disease-free survival rate. Total gastrectomy in the MIS group was associated with a higher complication rate than in the open group. Therefore, a new stable surgical technique needs to be established. More... »

PAGES

789-795

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-013-3256-1

DOI

http://dx.doi.org/10.1007/s00464-013-3256-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1040296660

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24263458


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36 schema:description Abstract Background This study aimed to compare the short- and long-term results of minimally invasive surgery (MIS) and open surgery for primary early gastric cancer (EGC) at a single high-volume institution.MethodsThe clinicopathologic and survival data of primary gastric cancer patients who underwent a minimally invasive radical gastrectomy at Seoul National University Hospital from December 2003 to January 2012 were retrospectively analyzed. For comparison of short-term outcomes, the data for 1,112 patients who underwent a radical open gastrectomy from 2007 to 2011 were collected. For long-term outcome analysis, the data for 962 patients who underwent a radical open gastrectomy from 2004 to 2006 were collected. Because the application of MIS was limited to suspected EGC, the control groups were similarly limited to patients deemed to have EGC as shown by preoperative endoscopy, endoscopic ultrasound, or both.ResultsThe review of our database identified 1,013 patients who had undergone MIS for gastric cancer. In the short-term outcome analysis, the MIS group showed statistically better results than the open surgery group in terms of postoperative hospital stay (8.7 vs. 11.3 days; p < 0.001), estimated blood loss (75.4 vs. 142.3 ml; p < 0.001), and overall complication rate (17.5 vs. 24.4 %; p < 0.001). In the subset analysis of total gastrectomy, the local complication rate was much higher in the MIS group than in the open surgery group. Both uni- and multivariate analyses showed that not only the surgical approach but also age, chronic liver disease, chronic renal disease, and additional organ resection had significant effects on complications. In the long-term outcome analysis, the two groups showed comparable disease-free survival rates.ConclusionsThe use of MIS for EGC showed a shorter operation time, a shorter postoperative hospital stay, and a lower overall complication rate than open surgery but a comparable disease-free survival rate. Total gastrectomy in the MIS group was associated with a higher complication rate than in the open group. Therefore, a new stable surgical technique needs to be established.
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44 MIS
45 MIS group
46 MethodsThe clinicopathologic
47 National University Hospital
48 Seoul National University Hospital
49 University Hospital
50 additional organ resection
51 age
52 analysis
53 application of MIS
54 applications
55 approach
56 background
57 better results
58 blood loss
59 cancer
60 cancer patients
61 chronic liver disease
62 chronic renal disease
63 clinicopathologic
64 comparable disease-free survival rates
65 comparison
66 complication rate
67 complications
68 control group
69 data
70 database
71 disease
72 disease-free survival rates
73 early gastric cancer
74 effect
75 endoscopic ultrasound
76 endoscopy
77 gastrectomy
78 gastric cancer
79 gastric cancer patients
80 group
81 high complication rate
82 high-volume institutions
83 hospital
84 hospital stay
85 institutions
86 invasive radical gastrectomy
87 invasive surgery
88 liver disease
89 local complication rate
90 long-term outcome analysis
91 long-term results
92 loss
93 lower overall complication rate
94 multivariate analysis
95 new stable surgical technique
96 open gastrectomy
97 open group
98 open surgery
99 open surgery group
100 operation time
101 organ resection
102 outcome analysis
103 outcomes
104 overall complication rate
105 patients
106 postoperative hospital stay
107 preoperative endoscopy
108 primary early gastric cancer
109 primary gastric cancer patients
110 radical gastrectomy
111 radical open gastrectomy
112 rate
113 renal disease
114 resection
115 results
116 review
117 short-term outcome analysis
118 short-term outcomes
119 shorter operation time
120 shorter postoperative hospital stay
121 significant effect
122 single high-volume institution
123 single institution
124 stable surgical technique
125 stay
126 study
127 subset analysis
128 surgery
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130 surgical approach
131 surgical technique
132 survival data
133 survival rate
134 technique
135 terms
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137 total gastrectomy
138 ultrasound
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