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Erschienen in: Surgical Endoscopy 8/2016

28.10.2015

Late phase II study of robot-assisted gastrectomy with nodal dissection for clinical stage I gastric cancer

verfasst von: Masanori Tokunaga, Rie Makuuchi, Yuiciro Miki, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, Masanori Terashima

Erschienen in: Surgical Endoscopy | Ausgabe 8/2016

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Abstract

Background

The feasibility of robot-assisted gastrectomy (RG) in terms of safety is unclear due to a lack of prospective studies. We showed feasible surgical outcomes in our previous study. In this phase II study, we assessed feasibility of the procedure by recruiting a larger number of patients.

Method

This single-center, prospective phase II study included patients with clinical stage I gastric cancer undergoing RG. The primary end point was the incidence of postoperative intra-abdominal infectious complications, including anastomotic leakage, pancreas-related infection, and intra-abdominal abscess. The secondary end points were overall survival, relapse-free survival, RG completion rate, and incidence of all surgical morbidities.

Results

A total of 120 patients were recruited between December 2012 and April 2015. The incidence of intra-abdominal infectious complications was 3.3 % (95 % CI 0.9–8.3 %), and all complications were successfully treated conservatively without re-operation. The incidence of overall adverse events was 14.2 % (95 % CI 8.5–21.7 %). Three patients required conversion to open gastrectomy according to the protocol due to advancement of disease.

Conclusion

Our data show that RG is safe in terms of the incidence and severity of postoperative complications.
Literatur
1.
Zurück zum Zitat Takagi M, Katai H, Mizusawa J, Nakamura K, Yoshikawa T, Terashima M et al (2015) A phase III study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage IA/IB gastric cancer (JCOG0912): analysis of the safety and short-term clinical outcomes. J Clin Oncol 33:(suppl; abstract 4017) Takagi M, Katai H, Mizusawa J, Nakamura K, Yoshikawa T, Terashima M et al (2015) A phase III study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage IA/IB gastric cancer (JCOG0912): analysis of the safety and short-term clinical outcomes. J Clin Oncol 33:(suppl; abstract 4017)
2.
Zurück zum Zitat Lee HJ, Kim HH, Han SU, Kim MC, Hyung WJ, Ryu SW et al (2015) Morbidity and mortality after laparoscopy-assisted and open distal gastrectomy for stage I gastric cancer: results from a multicenter randomized controlled trial (KLASS-01). J Clin Oncol 33:(suppl 3; abstract 4) Lee HJ, Kim HH, Han SU, Kim MC, Hyung WJ, Ryu SW et al (2015) Morbidity and mortality after laparoscopy-assisted and open distal gastrectomy for stage I gastric cancer: results from a multicenter randomized controlled trial (KLASS-01). J Clin Oncol 33:(suppl 3; abstract 4)
3.
Zurück zum Zitat Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W et al (2010) Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report—a phase III multicenter, prospective, randomized trial (KLASS Trial). Ann Surg 251:417–420CrossRefPubMed Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W et al (2010) Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report—a phase III multicenter, prospective, randomized trial (KLASS Trial). Ann Surg 251:417–420CrossRefPubMed
4.
Zurück zum Zitat Katai H (2015) Current status of a randomized controlled trial examining laparoscopic gastrectomy for gastric cancer in Japan. Asian J Endosc Surg 8:125–129CrossRefPubMed Katai H (2015) Current status of a randomized controlled trial examining laparoscopic gastrectomy for gastric cancer in Japan. Asian J Endosc Surg 8:125–129CrossRefPubMed
5.
Zurück zum Zitat Nakamura K, Katai H, Mizusawa J, Yoshikawa T, Ando M, Terashima M et al (2013) A phase III study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage IA/IB gastric Cancer (JCOG0912). Jpn J Clin Oncol 43:324–327CrossRefPubMed Nakamura K, Katai H, Mizusawa J, Yoshikawa T, Ando M, Terashima M et al (2013) A phase III study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage IA/IB gastric Cancer (JCOG0912). Jpn J Clin Oncol 43:324–327CrossRefPubMed
6.
7.
Zurück zum Zitat Tokunaga M, Hiki N, Fukunaga T, Nohara K, Katayama H, Akashi Y et al (2009) Laparoscopy-assisted distal gastrectomy with D2 lymph node dissection following standardization—a preliminary study. J Gastrointest Surg 13:1058–1063CrossRefPubMed Tokunaga M, Hiki N, Fukunaga T, Nohara K, Katayama H, Akashi Y et al (2009) Laparoscopy-assisted distal gastrectomy with D2 lymph node dissection following standardization—a preliminary study. J Gastrointest Surg 13:1058–1063CrossRefPubMed
8.
Zurück zum Zitat Kunisaki C, Makino H, Takagawa R, Kimura J, Ota M, Ichikawa Y et al (2015) A systematic review of laparoscopic total gastrectomy for gastric cancer. Gastric Cancer 18:218–226CrossRefPubMed Kunisaki C, Makino H, Takagawa R, Kimura J, Ota M, Ichikawa Y et al (2015) A systematic review of laparoscopic total gastrectomy for gastric cancer. Gastric Cancer 18:218–226CrossRefPubMed
9.
Zurück zum Zitat Song J, Oh SJ, Kang WH, Hyung WJ, Choi SH, Noh SH (2009) Robot-assisted gastrectomy with lymph node dissection for gastric cancer: lessons learned from an initial 100 consecutive procedures. Ann Surg 249:927–932CrossRefPubMed Song J, Oh SJ, Kang WH, Hyung WJ, Choi SH, Noh SH (2009) Robot-assisted gastrectomy with lymph node dissection for gastric cancer: lessons learned from an initial 100 consecutive procedures. Ann Surg 249:927–932CrossRefPubMed
10.
Zurück zum Zitat Song J, Kang WH, Oh SJ, Hyung WJ, Choi SH, Noh SH (2009) Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: initial experience of 20 consecutive cases. Surg Endosc 23:1204–1211CrossRefPubMed Song J, Kang WH, Oh SJ, Hyung WJ, Choi SH, Noh SH (2009) Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: initial experience of 20 consecutive cases. Surg Endosc 23:1204–1211CrossRefPubMed
11.
Zurück zum Zitat Isogaki J, Haruta S, Man-i M, Suda K, Kawamura Y, Yoshimura F et al (2011) Robot-assisted surgery for gastric cancer: experience at our institute. Pathobiology 78:328–333CrossRefPubMed Isogaki J, Haruta S, Man-i M, Suda K, Kawamura Y, Yoshimura F et al (2011) Robot-assisted surgery for gastric cancer: experience at our institute. Pathobiology 78:328–333CrossRefPubMed
12.
Zurück zum Zitat Hyun MH, Lee CH, Kwon YJ, Cho SI, Jang YJ, Kim DH et al (2013) Robot versus laparoscopic gastrectomy for cancer by an experienced surgeon: comparisons of surgery, complications, and surgical stress. Ann Surg Oncol 20:1258–1265CrossRefPubMed Hyun MH, Lee CH, Kwon YJ, Cho SI, Jang YJ, Kim DH et al (2013) Robot versus laparoscopic gastrectomy for cancer by an experienced surgeon: comparisons of surgery, complications, and surgical stress. Ann Surg Oncol 20:1258–1265CrossRefPubMed
13.
Zurück zum Zitat Yoon HM, Kim YW, Lee JH, Ryu KW, Eom BW, Park JY et al (2012) Robot-assisted total gastrectomy is comparable with laparoscopically assisted total gastrectomy for early gastric cancer. Surg Endosc 26:1377–1381CrossRefPubMed Yoon HM, Kim YW, Lee JH, Ryu KW, Eom BW, Park JY et al (2012) Robot-assisted total gastrectomy is comparable with laparoscopically assisted total gastrectomy for early gastric cancer. Surg Endosc 26:1377–1381CrossRefPubMed
14.
Zurück zum Zitat Park JY, Jo MJ, Nam BH, Kim Y, Eom BW, Yoon HM et al (2012) Surgical stress after robot-assisted distal gastrectomy and its economic implications. Br J Surg 99:1554–1561CrossRefPubMed Park JY, Jo MJ, Nam BH, Kim Y, Eom BW, Yoon HM et al (2012) Surgical stress after robot-assisted distal gastrectomy and its economic implications. Br J Surg 99:1554–1561CrossRefPubMed
15.
Zurück zum Zitat Tokunaga M, Sugisawa N, Kondo J, Tanizawa Y, Bando E, Kawamura T et al (2014) Early phase II study of robot-assisted distal gastrectomy with nodal dissection for clinical stage IA gastric cancer. Gastric Cancer 17:542–547CrossRefPubMed Tokunaga M, Sugisawa N, Kondo J, Tanizawa Y, Bando E, Kawamura T et al (2014) Early phase II study of robot-assisted distal gastrectomy with nodal dissection for clinical stage IA gastric cancer. Gastric Cancer 17:542–547CrossRefPubMed
16.
Zurück zum Zitat Sobin LH, Gospodarowicz MK, Wittekind C (eds) (2009) TNM classification of malignant tumors, 7th edn. Wiley, New York Sobin LH, Gospodarowicz MK, Wittekind C (eds) (2009) TNM classification of malignant tumors, 7th edn. Wiley, New York
17.
Zurück zum Zitat Association JapaneseGastricCancer (2011) Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 14:113–123CrossRef Association JapaneseGastricCancer (2011) Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 14:113–123CrossRef
18.
Zurück zum Zitat Sano T, Sasako M, Shibata T, Yamamoto S, Tsuburaya A, Nashimoto A et al (2010) Randomized controlled trial to evaluate splenectomy in total gastrectomy for proximal gastric carcinoma (JCOG0110): analyzes of operative morbidity, operation time, and blood loss. J Clin Oncol 28:15s (suppl; abstract 4020) Sano T, Sasako M, Shibata T, Yamamoto S, Tsuburaya A, Nashimoto A et al (2010) Randomized controlled trial to evaluate splenectomy in total gastrectomy for proximal gastric carcinoma (JCOG0110): analyzes of operative morbidity, operation time, and blood loss. J Clin Oncol 28:15s (suppl; abstract 4020)
19.
Zurück zum Zitat SanoT, Sasako M, Mizusawa J, Katayama H, Katai H, Yoshikawa T et al (2015) Randomized controlled trial to evaluate splenectomy in total gastrectomy for proximal gastric carcinoma (JCOG0110): final survival analysis. J Clin Oncol 33:(suppl 3; abstract 103) SanoT, Sasako M, Mizusawa J, Katayama H, Katai H, Yoshikawa T et al (2015) Randomized controlled trial to evaluate splenectomy in total gastrectomy for proximal gastric carcinoma (JCOG0110): final survival analysis. J Clin Oncol 33:(suppl 3; abstract 103)
20.
Zurück zum Zitat Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250:187–196CrossRefPubMed Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250:187–196CrossRefPubMed
21.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Eom BW, Yoon HM, Ryu KW, Lee JH, Cho SJ, Lee JY et al (2012) Comparison of surgical performance and short-term clinical outcomes between laparoscopic and robotic surgery in distal gastric cancer. Eur J Surg Oncol 38:57–63CrossRefPubMed Eom BW, Yoon HM, Ryu KW, Lee JH, Cho SJ, Lee JY et al (2012) Comparison of surgical performance and short-term clinical outcomes between laparoscopic and robotic surgery in distal gastric cancer. Eur J Surg Oncol 38:57–63CrossRefPubMed
23.
Zurück zum Zitat Huang KH, Lan YT, Fang WL, Chen JH, Lo SS, Hsieh MC et al (2012) Initial experience of robotic gastrectomy and comparison with open and laparoscopic gastrectomy for gastric cancer. J Gastrointest Surg 16:1303–1310CrossRefPubMed Huang KH, Lan YT, Fang WL, Chen JH, Lo SS, Hsieh MC et al (2012) Initial experience of robotic gastrectomy and comparison with open and laparoscopic gastrectomy for gastric cancer. J Gastrointest Surg 16:1303–1310CrossRefPubMed
24.
Zurück zum Zitat Kang BH, Xuan Y, Hur H, Ahn CW, Cho YK, Han SU (2012) Comparison of surgical outcomes between robotic and laparoscopic gastrectomy for gastric cancer: the learning curve of robotic surgery. J Gastric Cancer 12:156–163CrossRefPubMedPubMedCentral Kang BH, Xuan Y, Hur H, Ahn CW, Cho YK, Han SU (2012) Comparison of surgical outcomes between robotic and laparoscopic gastrectomy for gastric cancer: the learning curve of robotic surgery. J Gastric Cancer 12:156–163CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Kim KM, An JY, Kim HI, Cheong JH, Hyung WJ, Noh SH (2012) Major early complications following open, laparoscopic and robotic gastrectomy. Br J Surg 99:1681–1687CrossRefPubMed Kim KM, An JY, Kim HI, Cheong JH, Hyung WJ, Noh SH (2012) Major early complications following open, laparoscopic and robotic gastrectomy. Br J Surg 99:1681–1687CrossRefPubMed
26.
Zurück zum Zitat Uyama I, Kanaya S, Ishida Y, Inaba K, Suda K, Satoh S (2012) Novel integrated robotic approach for suprapancreatic D2 nodal dissection for treating gastric cancer: technique and initial experience. World J Surg 36:331–337CrossRefPubMed Uyama I, Kanaya S, Ishida Y, Inaba K, Suda K, Satoh S (2012) Novel integrated robotic approach for suprapancreatic D2 nodal dissection for treating gastric cancer: technique and initial experience. World J Surg 36:331–337CrossRefPubMed
27.
Zurück zum Zitat Han DS, Suh YS, Ahn HS, Kong SH, Lee HJ, Kim WH et al (2015) Comparison of surgical outcomes of robot-assisted and laparoscopy-assisted pylorus-preserving gastrectomy for gastric cancer: a propensity score matching analysis. Ann Surg Oncol 22:2323–2328CrossRefPubMed Han DS, Suh YS, Ahn HS, Kong SH, Lee HJ, Kim WH et al (2015) Comparison of surgical outcomes of robot-assisted and laparoscopy-assisted pylorus-preserving gastrectomy for gastric cancer: a propensity score matching analysis. Ann Surg Oncol 22:2323–2328CrossRefPubMed
28.
Zurück zum Zitat Seo HS, Shim JH, Jeon HM, Park CH, Song KY (2015) Postoperative pancreatic fistula after robot distal gastrectomy. J Surg Res 194:361–366CrossRefPubMed Seo HS, Shim JH, Jeon HM, Park CH, Song KY (2015) Postoperative pancreatic fistula after robot distal gastrectomy. J Surg Res 194:361–366CrossRefPubMed
29.
Zurück zum Zitat Son T, Lee JH, Kim YM, Kim HI, Noh SH, Hyung WJ (2014) Robotic spleen-preserving total gastrectomy for gastric cancer: comparison with conventional laparoscopic procedure. Surg Endosc 28:2606–2615CrossRefPubMed Son T, Lee JH, Kim YM, Kim HI, Noh SH, Hyung WJ (2014) Robotic spleen-preserving total gastrectomy for gastric cancer: comparison with conventional laparoscopic procedure. Surg Endosc 28:2606–2615CrossRefPubMed
30.
Zurück zum Zitat Lee J, Kim YM, Woo Y, Obama K, Noh SH, Hyung WJ (2015) Robotic distal subtotal gastrectomy with D2 lymphadenectomy for gastric cancer patients with high body mass index: comparison with conventional laparoscopic distal subtotal gastrectomy with D2 lymphadenectomy. Surg Endosc 29(11):3251–3260CrossRefPubMed Lee J, Kim YM, Woo Y, Obama K, Noh SH, Hyung WJ (2015) Robotic distal subtotal gastrectomy with D2 lymphadenectomy for gastric cancer patients with high body mass index: comparison with conventional laparoscopic distal subtotal gastrectomy with D2 lymphadenectomy. Surg Endosc 29(11):3251–3260CrossRefPubMed
31.
Zurück zum Zitat Park JY, Ryu KW, Reim D, Eom BW, Yoon HM, Rho JY et al (2015) Robot-assisted gastrectomy for early gastric cancer: is it beneficial in viscerally obese patients compared to laparoscopic gastrectomy? World J Surg 39:1789–1797CrossRefPubMed Park JY, Ryu KW, Reim D, Eom BW, Yoon HM, Rho JY et al (2015) Robot-assisted gastrectomy for early gastric cancer: is it beneficial in viscerally obese patients compared to laparoscopic gastrectomy? World J Surg 39:1789–1797CrossRefPubMed
32.
Zurück zum Zitat Terashima M, Tokunaga M, Tanizawa Y, Bando E, Kawamura T, Miki Y et al (2015) Robotic surgery for gastric cancer. Gastric Cancer 18:449–457CrossRefPubMed Terashima M, Tokunaga M, Tanizawa Y, Bando E, Kawamura T, Miki Y et al (2015) Robotic surgery for gastric cancer. Gastric Cancer 18:449–457CrossRefPubMed
33.
Zurück zum Zitat Kim HI, Han SU, Yang HK, Kim YW, Lee HJ, Ryu KW et al (2015) Multicenter prospective comparative study of robotic versus laparoscopic gastrectomy for gastric adenocarcinoma. Ann Surg (Epub ahead of print) Kim HI, Han SU, Yang HK, Kim YW, Lee HJ, Ryu KW et al (2015) Multicenter prospective comparative study of robotic versus laparoscopic gastrectomy for gastric adenocarcinoma. Ann Surg (Epub ahead of print)
34.
Zurück zum Zitat Tokunaga M, Sugisawa N, Tanizawa Y, Bando E, Kawamura T, Terashima M (2013) The impact of preoperative lymph node size on long-term outcome following curative gastrectomy for gastric cancer. Ann Surg Oncol 20:1598–1603CrossRefPubMed Tokunaga M, Sugisawa N, Tanizawa Y, Bando E, Kawamura T, Terashima M (2013) The impact of preoperative lymph node size on long-term outcome following curative gastrectomy for gastric cancer. Ann Surg Oncol 20:1598–1603CrossRefPubMed
35.
Zurück zum Zitat Tokunaga M, Sano T, Ohyama S, Hiki N, Fukunaga T, Yamada K et al (2013) Clinicopathological characteristics and survival difference between gastric stump carcinoma and primary upper third gastric cancer. J Gastrointest Surg 17:313–318CrossRefPubMed Tokunaga M, Sano T, Ohyama S, Hiki N, Fukunaga T, Yamada K et al (2013) Clinicopathological characteristics and survival difference between gastric stump carcinoma and primary upper third gastric cancer. J Gastrointest Surg 17:313–318CrossRefPubMed
36.
Zurück zum Zitat Uyama I, Kanaya S, Ishida Y, Inaba K, Suda K, Satoh S (2012) Novel integrated robotic approach for suprapancreatic D2 nodal dissection for treating gastric cancer: technique and initial experience. World J Surg 36(2):331–337CrossRefPubMed Uyama I, Kanaya S, Ishida Y, Inaba K, Suda K, Satoh S (2012) Novel integrated robotic approach for suprapancreatic D2 nodal dissection for treating gastric cancer: technique and initial experience. World J Surg 36(2):331–337CrossRefPubMed
37.
Zurück zum Zitat Noshiro H, Ikeda O, Urata M (2014) Robotically-enhanced surgical anatomy enables surgeons to perform distal gastrectomy for gastric cancer using electric cautery devices alone. Surg Endosc 28(4):1180–1187CrossRefPubMed Noshiro H, Ikeda O, Urata M (2014) Robotically-enhanced surgical anatomy enables surgeons to perform distal gastrectomy for gastric cancer using electric cautery devices alone. Surg Endosc 28(4):1180–1187CrossRefPubMed
38.
Zurück zum Zitat Tokunaga M, Tanizawa Y, Bando E, Kawamura T, Terashima M (2013) Poor survival rate in patients with postoperative intra-abdominal infectious complications following curative gastrectomy for gastric cancer. Ann Surg Oncol 20:1575–1583CrossRefPubMed Tokunaga M, Tanizawa Y, Bando E, Kawamura T, Terashima M (2013) Poor survival rate in patients with postoperative intra-abdominal infectious complications following curative gastrectomy for gastric cancer. Ann Surg Oncol 20:1575–1583CrossRefPubMed
Metadaten
Titel
Late phase II study of robot-assisted gastrectomy with nodal dissection for clinical stage I gastric cancer
verfasst von
Masanori Tokunaga
Rie Makuuchi
Yuiciro Miki
Yutaka Tanizawa
Etsuro Bando
Taiichi Kawamura
Masanori Terashima
Publikationsdatum
28.10.2015
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 8/2016
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4613-z

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