Share This Article:

Comparison of Laparoscopy-Assisted Gastrectomy and Conventional Open Gastrectomy with the Same Procedure in Early Distal Gastric Cancer

DOI: 10.4236/jct.2013.41A001    4,804 Downloads   7,602 Views   Citations

ABSTRACT

Introduction: Laparoscopy-assisted gastrectomy (LAG) for early gastric cancer (EGC) was considered as a treatment with many advantages due to the application of laparoscopic equipment. The aim of this study was to compare the effect of use of laparoscopic equipment in blood loss, the number of harvested lymph nodes (HLNs), and complications between LAG and open gastrectomy (OG) for EGC. Methods: Patients received surgical treatment for early distal gastric cancer (EDGC) were retrospectively reviewed. Patients were classified into three groups by different operation methods: traditional open distal gastrectomy (ODG) group, laparoscopy-assisted distal gastrectomy (LADG) group, and open distal gastrectomy with assistance of laparoscopic equipment (ODGA) group. Results: Altogether 65 patients with EDGC received surgical treatment, including 20 cases of ODG, 22 of LADG, and 23 of ODGA. No lymph node metastasis was found in all patients. 25 (38.5%) postoperative confirmed T2 were misdiagnosed as T1 preoperatively. Compared with ODG group, the blood loss was significantly reduced in LADG and ODGA groups (106.4 ± 46.0; and 73.3 ± 35.7 ml vs. 250.5 ± 65.1 ml respectively; P < 0.01), but the operation time was significantly longer in these groups (231.0 ± 34.5, and 222.5 ± 42.6 min vs. 128.5 ± 22.3 min respectively; P < 0.01). No difference was found in the blood loss, operation time, the number of harvested lymph nodes and the types of gastrointestinal continuity reconstruction between LADG and ODGA groups. No difference was found in the postoperative complications among the three groups. Conclusions: Laparoscopic equipment might be the key factor in the reduction of blood loss and the delay of operation time for LADG. Application of laparoscopic equipment in open gastrectomy can be used as a training method to shorten learning curve for LAG beginners.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

L. Sun, Z. Shu, Y. Zhang, D. Ding and Y. Li, "Comparison of Laparoscopy-Assisted Gastrectomy and Conventional Open Gastrectomy with the Same Procedure in Early Distal Gastric Cancer," Journal of Cancer Therapy, Vol. 4 No. 1A, 2013, pp. 1-5. doi: 10.4236/jct.2013.41A001.

References

[1] T. Etoh, M. Inomata, N. Shiraishi and S. Kitano, “Minimally Invasive Approaches for Gastric Cancer—Japanese Experiences,” Journal of Surgical Oncology, Vol. 13, 2012. doi:10.1002/jso.23128
[2] J. H. Lee, C. K. Yom and H. S. Han, “Comparison of Long-Term Outcomes of Laparoscopy-Assisted and open Distal Gastrectomy for Early Gastric Cancer,” Journal of Surgical Oncology, Vol. 23, No. 8, 2009, pp. 1759-1763. doi:10.1007/s00464-008-0198-0
[3] D. Yakoub, T. Athanasiou, P. Tekkis and G. B. Hanna, “Laparoscopic Assisted Distal Gastrectomy for Early Gastric Cancer: Is It an Alternative to the Open Approach?” Journal of Surgical Oncology, Vol. 18, No. 4, 2009, pp. 322-333. doi:10.1016/j.suronc.2008.08.006
[4] Z. Zhu, C. Wang, C. Xu and Q. Cai, “Influence of Patient-Controlled Epidural Analgesia versus Patient-Controlled Intravenous Analgesia on Postoperative Pain Control and Recovery after Gastrectomy for Gastric Cancer: A Prospective Randomized Trial,” Gastric Cancer, Vol. 18, 2012.
[5] H. J. Chen, J. L. Xin , L. Cai, Z. H. Tao, H. S. Yuan, C. H. Bing, et al. “Preliminary Experience of Fast-Track Surgery Combined with Laparoscopy-Assisted Radical Distal Gastrectomy for Gastric Cancer,” Journal of Gastrointestinal Surgery, Vol. 16, No. 10, 2012, 1830-1839. doi:10.1007/s11605-012-1969-4
[6] K. H. Kim, M. C. Kim, G. J. Jung and H. H. Kim, “Long-Term Outcomes and Feasibility with Laparoscopy-Assisted Gastrectomy for Gastric Cancer,” Journal of Gastric Cancer, Vol. 12, No. 1, 2012, pp. 18-25.
[7] M. Cui, J. D. Xing, W. Yang, Y. Y. Ma, Z. D. Yao, N. Zhang, et al, “D2 Dissection in Laparoscopic and Open Gastrectomy for Gastric Cancer,” World Journal of Gastroenterology, Vol. 18, No. 8, 2012, pp. 833-839. doi:10.3748/wjg.v18.i8.833
[8] H. Sato, M. Shimada, N. Kurita, T. Iwata, M. Nishioka, S. Morimoto, et al. “Comparison of Long-Term Prognosis of Laparoscopy-Assisted Gastrectomy and Conventional Open Gastrectomy with Special Reference to D2 Lymph Node Dissection,” Surgical Endoscopy, Vol. 26, No. 8, 2012, pp. 2240-2246. doi:10.1007/s00464-012-2167-x
[9] Y. K. Zeng, Z. L. Yang, J. S. Peng, H. S. Lin and L. Cai, “Laparoscopy-Assisted versus Open Distal Gastrectomy for Early Gastric Cancer: Evidence from Randomized and Nonrandomized Clinical Trials,” Annals of Surgery, Vol. 256, No. 1, 2012, pp. 39-52. doi:10.1097/SLA.0b013e3182583e2e
[10] S. J. Yang, E. J. Ahn, S. H. Park, J. H. Kim and J. M. Park, “The Early Experience of Laparoscopy-Assisted Gastrectomy for Gastric Cancer at a Low-Volume Center,” Journal of Gastric Cancer, Vol. 10, No. 4, 2010, pp. 241-246. doi:10.5230/jgc.2010.10.4.241
[11] Y. Liang, G. Li, P. Chen, J. Yu and C. Zhang, “Laparoscopic versus Open Gastrectomy for Early Distal Gastric Cancer: A Meta-Analysis,” ANZ Journal of Surgery, Vol. 81, No. 10, 2011, pp. 673-680. doi:10.1111/j.1445-2197.2010.05599.x
[12] S. E. Lee, J. H. Lee, M. C. Kook, J. S. Yoo, K. W. Ryu, J. S. Lee, et al. “T2 or Greater Disease but Were Diagnosed Preoperatively with Early Gastric Cancer,” Hepatogastroenterology, Vol. 55, No. 88, 2008, pp. 2282-2286.
[13] H. Ohtani, Y. Tamamori, K. Noguchi, T. Azuma, S. Fujimoto, H. Oba, et al. “A Meta-Analysis of Randomized Controlled Trials That Compared Laparoscopy-Assisted and Open Distal Gastrectomy for Early Gastric Cancer, Journal of Gastrointestinal Surgery, Vol. 14. No. 6, 2010, pp. 958-964. doi:10.1007/s11605-010-1195-x
[14] M. Tokunaga, N. Hiki, T. Fukunaga, A. Miki, S. Ohyama, S. Miyata, et al. “Learning Curve of Laparoscopy-Assisted Gastrectomy Using a Standardized Surgical Technique and an Established Educational System,” Scandinavian Journal of Surgery, Vol. 100, No. 2, 2011, pp. 86-91.
[15] T. Kinoshita, E. Kanehira, M. Matsuda, S. Okazumi and R. Katoh, “Effectiveness of a Team Participation Training Course for Laparoscopy-Assisted Gastrectomy,” Surgical Endoscopy, Vol. 24, No. 3, 2010, pp. 561-566. doi:10.1007/s00464-009-0607-z
[16] M. G. Kim, K. C. Kim, J. H. Yook, B. S. Kim, T. H. Kim and B. S. Kim, “A Practical Way to Overcome the Learning Period of Laparoscopic Gastrectomy for Gastric Cancer,” Surgical Endoscopy, Vol. 25, No. 12, 2011, pp. 3838-3844. doi:10.1007/s00464-011-1801-3
[17] C. H. Yoo, H. O. Kim, S. I. Hwang, B. H. Son, J. H. Shin and H. Kim, “Short-Term Outcomes of laparoscopic-Assisted Distal Gastrectomy for Gastric Cancer During a Surgeon’s Learning Curve Period,” Surgical Endoscopy, Vol. 23, No. 10, 2009, pp. 2250-2257. doi:10.1007/s00464-008-0315-0
[18] J. H. Han, H. J. Lee, Y. S. Suh, D. S. Han, S. H. Kong and H. K. Yang, “Laparoscopy-Assisted Distal Gastrectomy Compared to Open Distal Gastrectomy in Early Gastric Cancer,” Digestive Surgery, Vol. 28, No. 4, 2011, pp. 245-251. doi:10.1159/000328658

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.