Laparoscopic proximal gastrectomy with double tract reconstruction is superior to laparoscopic total gastrectomy for proximal early gastric cancer View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-03-24

AUTHORS

Do Hyun Jung, Yoontaek Lee, Dong Wook Kim, Young Suk Park, Sang-Hoon Ahn, Do Joong Park, Hyung-Ho Kim

ABSTRACT

BackgroundLaparoscopic proximal gastrectomy (LPG) with double tract reconstruction (DTR) is known to reduce reflux symptoms, which is a major concern after proximal gastrectomy. The aim of this study is to compare retrospectively the clinical outcomes of patients undergoing LPG with DTR with those treated by laparoscopic total gastrectomy (LTG).MethodsNinety-two and 156 patients undergoing LPG with DTR and LTG for proximal stage I gastric cancer were retrospectively analyzed for short- and long-term clinical outcomes.ResultsThere were no significant differences in the demographics, T-stage, N-stage, and complications between the groups. The LPG with DTR group had a shorter operative time and lower estimated blood loss than the LTG group (198.3 vs. 225.4 min, p < 0.001; and 84.7 vs. 128.3 mL p = 0.001). The incidence of reflux symptoms ≥ Visick grade II did not significantly differ between the groups during a mean follow-up period of 37.2 months (1.1 vs. 1.9%, p = 0.999). The hemoglobin change was significantly lower in the LPG with DTR group compared to in the LTG group in the first and second postoperative years (5.03 vs. 9.18% p = 0.004; and 3.45 vs. 8.30%, p = 0.002, respectively), as was the mean amount of vitamin B12 supplements 2 years after operation (0.1 vs. 3.1 mg, p < 0.001). The overall survival rate was similar between the groups.ConclusionsLPG with DTR maintained comparable oncological safety and anastomosis-related late complications compared to LTG and is preferred over LTG in terms of preventing postoperative anemia and vitamin B12 deficiency. More... »

PAGES

3961-3969

References to SciGraph publications

  • 2009-06-27. A clinicopathological study of gastric stump carcinoma following proximal gastrectomy in GASTRIC CANCER
  • 2014-05-07. Long-term quality-of-life comparison of total gastrectomy and proximal gastrectomy by Postgastrectomy Syndrome Assessment Scale (PGSAS-45): a nationwide multi-institutional study in GASTRIC CANCER
  • 2014-12-07. The learning curve associated with laparoscopic total gastrectomy in GASTRIC CANCER
  • 2013-03-13. Laparoscopy-assisted proximal gastrectomy for early gastric cancer is an ugly duckling with unsolved concerns: oncological safety, late complications, and functional benefit in GASTRIC CANCER
  • 2013-03-16. Function-Preserving Gastrectomy for Early Gastric Cancer in ANNALS OF SURGICAL ONCOLOGY
  • 2013-12-06. Comparison of Perioperative and Long-term Outcomes of Total and Proximal Gastrectomy for Early Gastric Cancer: A Multi-institutional Retrospective Study in WORLD JOURNAL OF SURGERY
  • 2011-05-15. Japanese classification of gastric carcinoma: 3rd English edition in GASTRIC CANCER
  • 2012-12-20. Long-term Outcome after Proximal Gastrectomy with Jejunal Interposition for Gastric Cancer Compared with Total Gastrectomy in WORLD JOURNAL OF SURGERY
  • 2012-07-22. Comparative study of clinical outcomes between laparoscopy-assisted proximal gastrectomy (LAPG) and laparoscopy-assisted total gastrectomy (LATG) for proximal gastric cancer in GASTRIC CANCER
  • 2012-06-07. Laparoscopic Total Gastrectomy with D2 Lymphadenectomy for Advanced Gastric Cancer in WORLD JOURNAL OF SURGERY
  • 2014-09-12. Functional Outcomes and Quality of Life After Proximal Gastrectomy with Esophagogastrostomy Using a Narrow Gastric Conduit in ANNALS OF SURGICAL ONCOLOGY
  • 2013-09-20. Laparoscopic double-tract proximal gastrectomy for proximal early gastric cancer in GASTRIC CANCER
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    http://scigraph.springernature.com/pub.10.1007/s00464-017-5429-9

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    http://dx.doi.org/10.1007/s00464-017-5429-9

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    31 schema:description BackgroundLaparoscopic proximal gastrectomy (LPG) with double tract reconstruction (DTR) is known to reduce reflux symptoms, which is a major concern after proximal gastrectomy. The aim of this study is to compare retrospectively the clinical outcomes of patients undergoing LPG with DTR with those treated by laparoscopic total gastrectomy (LTG).MethodsNinety-two and 156 patients undergoing LPG with DTR and LTG for proximal stage I gastric cancer were retrospectively analyzed for short- and long-term clinical outcomes.ResultsThere were no significant differences in the demographics, T-stage, N-stage, and complications between the groups. The LPG with DTR group had a shorter operative time and lower estimated blood loss than the LTG group (198.3 vs. 225.4 min, p < 0.001; and 84.7 vs. 128.3 mL p = 0.001). The incidence of reflux symptoms ≥ Visick grade II did not significantly differ between the groups during a mean follow-up period of 37.2 months (1.1 vs. 1.9%, p = 0.999). The hemoglobin change was significantly lower in the LPG with DTR group compared to in the LTG group in the first and second postoperative years (5.03 vs. 9.18% p = 0.004; and 3.45 vs. 8.30%, p = 0.002, respectively), as was the mean amount of vitamin B12 supplements 2 years after operation (0.1 vs. 3.1 mg, p < 0.001). The overall survival rate was similar between the groups.ConclusionsLPG with DTR maintained comparable oncological safety and anastomosis-related late complications compared to LTG and is preferred over LTG in terms of preventing postoperative anemia and vitamin B12 deficiency.
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    38 schema:keywords B12 deficiency
    39 B12 supplements 2 years
    40 BackgroundLaparoscopic proximal gastrectomy
    41 ConclusionsLPG
    42 DTR group
    43 I gastric cancer
    44 LPG
    45 LTG group
    46 MethodsNinety
    47 ResultsThere
    48 Visick grade II
    49 aim
    50 amount
    51 anastomosis-related late complications
    52 anemia
    53 blood loss
    54 cancer
    55 changes
    56 clinical outcomes
    57 comparable oncological safety
    58 complications
    59 concern
    60 deficiency
    61 demographics
    62 differences
    63 double tract reconstruction
    64 early gastric cancer
    65 follow
    66 gastrectomy
    67 gastric cancer
    68 grade II
    69 group
    70 hemoglobin change
    71 incidence
    72 laparoscopic proximal gastrectomy
    73 laparoscopic total gastrectomy
    74 late complications
    75 long-term clinical outcomes
    76 loss
    77 major concern
    78 mean amount
    79 mean follow
    80 months
    81 oncological safety
    82 operation
    83 operative time
    84 outcomes
    85 overall survival rate
    86 patients
    87 period
    88 postoperative anemia
    89 postoperative year
    90 proximal early gastric cancer
    91 proximal gastrectomy
    92 proximal stage I gastric cancer
    93 rate
    94 reconstruction
    95 reflux symptoms
    96 safety
    97 second postoperative year
    98 shorter operative time
    99 significant differences
    100 stage
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    102 study
    103 supplements 2 years
    104 survival rate
    105 symptoms
    106 terms
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    108 total gastrectomy
    109 tract reconstruction
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    111 vitamin B12 supplements 2 years
    112 years
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