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Erschienen in: Surgical Endoscopy 9/2008

01.09.2008

Laparoscopically assisted total gastrectomy with lymph node dissection for upper and middle gastric cancer

verfasst von: Erito Mochiki, Yoshitaka Toyomasu, Kyouichi Ogata, Hiroyuki Andoh, Tetsuro Ohno, Ryusuke Aihara, Takayuki Asao, Hiroyuki Kuwano

Erschienen in: Surgical Endoscopy | Ausgabe 9/2008

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Abstract

Background

In recent years, laparoscopic gastrectomy has been applied for the treatment of gastric cancer in Japan and Western countries. This report describes the short- and long-term results for patients with gastric cancer who underwent laparoscopically assisted total gastrectomy (LATG) with lymph node dissection.

Methods

From September 1999 to December 2007, 20 patients underwent LATG, and 18 underwent conventional open total gastrectomy (OTG) for upper and middle gastric cancer. The indications for LATG included depth of tumor invasion limited to the mucosa or submucosa and absence of lymph node metastases in preoperative examinations. The LATG and OTG procedures for gastric cancer were compared in terms of pathologic findings, operative outcome, complications, and survival.

Results

No significant difference was found between LATG and OTG in terms of operation time (254 vs 248 min.), number of lymph nodes (26 vs 35), complication rate (25% vs 17%), or 5-year cumulative survival rate (95% vs 90.9%). Differences between LATG and OTG were found with regard to blood loss (299 vs 758 g) and postoperative hospitalization (19 vs 29 days).

Conclusion

For properly selected patients, laparoscopically assisted total gastrectomy can be a curative and minimally invasive treatment for early gastric cancer.
Literatur
1.
Zurück zum Zitat Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N (2007) A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg 245:68–72PubMedCrossRef Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N (2007) A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg 245:68–72PubMedCrossRef
2.
Zurück zum Zitat Mochiki E, Kaniyama Y, Aihara R, Nakabayashi T, Asao T, Kuwano H (2005) Laparoscopic assisted distal gastrectomy for early gastric cancer: five years experience. Surgery 137:317–322PubMedCrossRef Mochiki E, Kaniyama Y, Aihara R, Nakabayashi T, Asao T, Kuwano H (2005) Laparoscopic assisted distal gastrectomy for early gastric cancer: five years experience. Surgery 137:317–322PubMedCrossRef
3.
Zurück zum Zitat Huscher CGS, Mingoli A, Sgarzini G, Sansonetti A, Di Paola M, Recher A, Ponzano C (2005) Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg 241:232–237PubMedCrossRef Huscher CGS, Mingoli A, Sgarzini G, Sansonetti A, Di Paola M, Recher A, Ponzano C (2005) Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg 241:232–237PubMedCrossRef
4.
Zurück zum Zitat Adachi Y, Suematsu T, Shiraishi N, Katsuta T, Morimoto A, Kitano S, Akazawa K (1999) Quality of life after laparoscopy-assisted Billroth I gastrectomy. Ann Surg 229:49–54PubMedCrossRef Adachi Y, Suematsu T, Shiraishi N, Katsuta T, Morimoto A, Kitano S, Akazawa K (1999) Quality of life after laparoscopy-assisted Billroth I gastrectomy. Ann Surg 229:49–54PubMedCrossRef
5.
Zurück zum Zitat Mochiki E, Nakabayashi T, Kamimura H, Haga N, Asao T, Kuwano H (2002) Gastrointestinal recover and outcome after laparoscopy-assisted versus conventional open distal gastrectomy for early gastric cancer. World J Surg 26:1145–1149PubMedCrossRef Mochiki E, Nakabayashi T, Kamimura H, Haga N, Asao T, Kuwano H (2002) Gastrointestinal recover and outcome after laparoscopy-assisted versus conventional open distal gastrectomy for early gastric cancer. World J Surg 26:1145–1149PubMedCrossRef
6.
Zurück zum Zitat Tanimura S, Higashino M, Fukunaga Y, Kishida S, Ogata A, Fujiwara Y, Osugi H (2007) Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer. Br J Surg 94:204–207PubMedCrossRef Tanimura S, Higashino M, Fukunaga Y, Kishida S, Ogata A, Fujiwara Y, Osugi H (2007) Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer. Br J Surg 94:204–207PubMedCrossRef
7.
Zurück zum Zitat Mochiki E, Kamimura H, Haga N, Asao T, Kuwano H (2002) The technique of laparoscopically assisted total gastrectomy with jejunal interposition for early gastric cancer. Surg Laparosc 16:540–544 Mochiki E, Kamimura H, Haga N, Asao T, Kuwano H (2002) The technique of laparoscopically assisted total gastrectomy with jejunal interposition for early gastric cancer. Surg Laparosc 16:540–544
8.
Zurück zum Zitat Huscher CGS, Mingoli A, Sgarzini G, Brachini G, Binda B, Paola MD, Ponzano C (2007) Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer: early and long-term results of a 100-patients series. Am J Surg 194:839–844PubMedCrossRef Huscher CGS, Mingoli A, Sgarzini G, Brachini G, Binda B, Paola MD, Ponzano C (2007) Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer: early and long-term results of a 100-patients series. Am J Surg 194:839–844PubMedCrossRef
9.
Zurück zum Zitat Pugliese R, Maggioni D, Sansonna F, Scandroglio I, Ferrari GC, Di Lernia S, Costanzi A, Pauna J, de Martini P (2007) Total and subtotal laparoscopic gastrectomy for adenocarcinoma. Surg Endosc 21:21–27PubMedCrossRef Pugliese R, Maggioni D, Sansonna F, Scandroglio I, Ferrari GC, Di Lernia S, Costanzi A, Pauna J, de Martini P (2007) Total and subtotal laparoscopic gastrectomy for adenocarcinoma. Surg Endosc 21:21–27PubMedCrossRef
10.
Zurück zum Zitat Dulucq JL, Wintringer P, Perissat J, Mahajna A (2005) Completely laparoscopic total and partial gastrectomy for benign and malignant diseases: a single institute’s prospective analysis. J Am Coll Surg 200:191–197PubMedCrossRef Dulucq JL, Wintringer P, Perissat J, Mahajna A (2005) Completely laparoscopic total and partial gastrectomy for benign and malignant diseases: a single institute’s prospective analysis. J Am Coll Surg 200:191–197PubMedCrossRef
11.
Zurück zum Zitat Omori T, Nakajima K, Endo S, Takahashi T, Hasegawa J, Nishida T (2006) Laparoscopically assisted total gastrectomy with jejuna pouch interposition. Surg Endosc 20:1497–1500PubMedCrossRef Omori T, Nakajima K, Endo S, Takahashi T, Hasegawa J, Nishida T (2006) Laparoscopically assisted total gastrectomy with jejuna pouch interposition. Surg Endosc 20:1497–1500PubMedCrossRef
12.
Zurück zum Zitat Tanimura S, Higashino M, Fukunaga Y, Kishida S, Ogata A, Fujiwara Y, Osugi H (2007) Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer. Br J Surg 94:204–207PubMedCrossRef Tanimura S, Higashino M, Fukunaga Y, Kishida S, Ogata A, Fujiwara Y, Osugi H (2007) Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer. Br J Surg 94:204–207PubMedCrossRef
13.
Zurück zum Zitat Asao T, Hosouchi Y, Nakabayashi T, Haga N, Mochiki E, Kuwano H (2001) Laparoscopically assisted total or distal gastrectomy with lymph node dissection for early gastric cancer. Br J Surg 88:128–132PubMedCrossRef Asao T, Hosouchi Y, Nakabayashi T, Haga N, Mochiki E, Kuwano H (2001) Laparoscopically assisted total or distal gastrectomy with lymph node dissection for early gastric cancer. Br J Surg 88:128–132PubMedCrossRef
14.
Zurück zum Zitat Ganpathi IS, So JBY, Ho KY (2006) Endoscopic ultrasonography for gastric cancer: does it influence treatment? Surg Endosc 20:559–562PubMedCrossRef Ganpathi IS, So JBY, Ho KY (2006) Endoscopic ultrasonography for gastric cancer: does it influence treatment? Surg Endosc 20:559–562PubMedCrossRef
15.
Zurück zum Zitat Davies MM, Larson DW (2004) Laparoscopic surgery for colorectal cancer: the state of the art. Surg Oncol 13:111–118PubMedCrossRef Davies MM, Larson DW (2004) Laparoscopic surgery for colorectal cancer: the state of the art. Surg Oncol 13:111–118PubMedCrossRef
16.
Zurück zum Zitat Shoup M, Brennan MF, Karpeh MS, Gillern Sm, McMahon RL, Conlon KC (2002) Port-site metastasis after diagnostic laparoscopy for upper gastrointestinal tract malignancies: an uncommon entity. Ann Surg Oncol 9:632–636PubMedCrossRef Shoup M, Brennan MF, Karpeh MS, Gillern Sm, McMahon RL, Conlon KC (2002) Port-site metastasis after diagnostic laparoscopy for upper gastrointestinal tract malignancies: an uncommon entity. Ann Surg Oncol 9:632–636PubMedCrossRef
17.
Zurück zum Zitat Lee YJ, Ha WS, Park ST, Choi SK Hong SC (2007) Port-site recurrence after laparoscopy-assisted gastrectomy: report of the first case. J Laparoendosc Adv Surg Tech A 17:455–457PubMedCrossRef Lee YJ, Ha WS, Park ST, Choi SK Hong SC (2007) Port-site recurrence after laparoscopy-assisted gastrectomy: report of the first case. J Laparoendosc Adv Surg Tech A 17:455–457PubMedCrossRef
18.
Zurück zum Zitat Adachi Y, Shiraishi N, Ikebe K, Aramaki M, Bandoh T, Kitano S (2001) Evaluation of the cost for laparoscopic-assisted Billroth I gastrectomy. Surg Endosc 15:932–936PubMedCrossRef Adachi Y, Shiraishi N, Ikebe K, Aramaki M, Bandoh T, Kitano S (2001) Evaluation of the cost for laparoscopic-assisted Billroth I gastrectomy. Surg Endosc 15:932–936PubMedCrossRef
19.
Zurück zum Zitat Song KY, Park CH, Kang HC, Kim JJ, Park SM, Jun KH, Chin HM, Hur H (2008) Is totally laparoscopic gastrectomy less invasive than laparoscopy-assisted gastrectomy? Prospective, multicenter study. J Gastrointest Surg 12:1015–1021PubMedCrossRef Song KY, Park CH, Kang HC, Kim JJ, Park SM, Jun KH, Chin HM, Hur H (2008) Is totally laparoscopic gastrectomy less invasive than laparoscopy-assisted gastrectomy? Prospective, multicenter study. J Gastrointest Surg 12:1015–1021PubMedCrossRef
Metadaten
Titel
Laparoscopically assisted total gastrectomy with lymph node dissection for upper and middle gastric cancer
verfasst von
Erito Mochiki
Yoshitaka Toyomasu
Kyouichi Ogata
Hiroyuki Andoh
Tetsuro Ohno
Ryusuke Aihara
Takayuki Asao
Hiroyuki Kuwano
Publikationsdatum
01.09.2008
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 9/2008
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-008-0015-9

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