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Erschienen in: Gastric Cancer 3/2014

01.07.2014 | Original Article

Early phase II study of robot-assisted distal gastrectomy with nodal dissection for clinical stage IA gastric cancer

verfasst von: Masanori Tokunaga, Norihiko Sugisawa, Junya Kondo, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, Masanori Terashima

Erschienen in: Gastric Cancer | Ausgabe 3/2014

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Abstract

Background

Robot-assisted distal gastrectomy (RADG) is increasingly performed in Japan and Korea and is thought to have many advantages over laparoscopic gastrectomy. However, a prospective study investigating the safety of RADG has never been reported. The present study evaluated the safety of RADG with nodal dissection for clinical stage IA gastric cancer.

Methods

This single-center, prospective phase II study included patients with clinical stage IA gastric cancer located within the lower two-thirds of the stomach. The primary endpoint was the incidence of postoperative intraabdominal infectious complications including anastomotic leakage, pancreas-related infection, and intraabdominal abscess. The secondary endpoints included all in-hospital adverse events, RADG completion rate, and survival outcome.

Results

From May 2012 to November 2012, 18 eligible patients were enrolled for this study. The incidence of intraabdominal infectious complication was 0 % (90 % CI, 0–12.0 %). The overall incidence of in-hospital adverse events was 22.2 % (90 % CI, 8.0–43.9 %). No patient required conversion to laparoscopic or open gastrectomy; thus, the RADG completion rate was 100 %.

Conclusions

This early phase II study suggested that RADG might be a safe and feasible procedure for stage IA gastric cancer, providing experienced surgeons perform the surgery. This conclusion should be clarified in subsequent late phase II studies with a larger sample size.
Literatur
1.
Zurück zum Zitat Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, Ryu SW, et al. 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. 2010;251(3):417–20.PubMedCrossRef Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, Ryu SW, et al. 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. 2010;251(3):417–20.PubMedCrossRef
2.
Zurück zum Zitat Katai H, Sasako M, Fukuda H, Nakamura K, Hiki N, Saka M, et al. Safety and feasibility of laparoscopy-assisted distal gastrectomy with supra-pancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG 0703). Gastric Cancer. 2010;13(4):238–44.PubMedCrossRef Katai H, Sasako M, Fukuda H, Nakamura K, Hiki N, Saka M, et al. Safety and feasibility of laparoscopy-assisted distal gastrectomy with supra-pancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG 0703). Gastric Cancer. 2010;13(4):238–44.PubMedCrossRef
3.
Zurück zum Zitat Nakamura K, Katai H, Mizusawa J, Yoshikawa T, Ando M, Terashima M, et al. 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. 2013;43(3):324–7.PubMedCrossRef Nakamura K, Katai H, Mizusawa J, Yoshikawa T, Ando M, Terashima M, et al. 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. 2013;43(3):324–7.PubMedCrossRef
4.
Zurück zum Zitat Song J, Oh SJ, Kang WH, Hyung WJ, Choi SH, Noh SH. Robot-assisted gastrectomy with lymph node dissection for gastric cancer: lessons learned from an initial 100 consecutive procedures. Ann Surg. 2009;249(6):927–32.PubMedCrossRef Song J, Oh SJ, Kang WH, Hyung WJ, Choi SH, Noh SH. Robot-assisted gastrectomy with lymph node dissection for gastric cancer: lessons learned from an initial 100 consecutive procedures. Ann Surg. 2009;249(6):927–32.PubMedCrossRef
5.
Zurück zum Zitat Song J, Kang WH, Oh SJ, Hyung WJ, Choi SH, Noh SH. Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: initial experience of 20 consecutive cases. Surg Endosc. 2009;23(6):1204–11.PubMedCrossRef Song J, Kang WH, Oh SJ, Hyung WJ, Choi SH, Noh SH. Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: initial experience of 20 consecutive cases. Surg Endosc. 2009;23(6):1204–11.PubMedCrossRef
6.
Zurück zum Zitat Hashizume M, Sugimachi K. Robot-assisted gastric surgery. Surg Clin N Am. 2003;83(6):1429–44.PubMedCrossRef Hashizume M, Sugimachi K. Robot-assisted gastric surgery. Surg Clin N Am. 2003;83(6):1429–44.PubMedCrossRef
7.
Zurück zum Zitat Kakeji Y, Konishi K, Ieiri S, Yasunaga T, Nakamoto M, Tanoue K, et al. Robotic laparoscopic distal gastrectomy: a comparison of the da Vinci and Zeus systems. Int J Med Robot. 2006;2(4):299–304.PubMedCrossRef Kakeji Y, Konishi K, Ieiri S, Yasunaga T, Nakamoto M, Tanoue K, et al. Robotic laparoscopic distal gastrectomy: a comparison of the da Vinci and Zeus systems. Int J Med Robot. 2006;2(4):299–304.PubMedCrossRef
8.
Zurück zum Zitat Isogaki J, Haruta S, Man IM, Suda K, Kawamura Y, Yoshimura F, et al. Robot-assisted surgery for gastric cancer: experience at our institute. Pathobiol J Immunopathol Mol Cell Biol. 2011;78(6):328–33.CrossRef Isogaki J, Haruta S, Man IM, Suda K, Kawamura Y, Yoshimura F, et al. Robot-assisted surgery for gastric cancer: experience at our institute. Pathobiol J Immunopathol Mol Cell Biol. 2011;78(6):328–33.CrossRef
9.
Zurück zum Zitat Park SS, Kim MC, Park MS, Hyung WJ Rapid adaptation of robotic gastrectomy for gastric cancer by experienced laparoscopic surgeons. Surg Endosc. 2012;26(1):60–7. Park SS, Kim MC, Park MS, Hyung WJ Rapid adaptation of robotic gastrectomy for gastric cancer by experienced laparoscopic surgeons. Surg Endosc. 2012;26(1):60–7.
10.
Zurück zum Zitat Lee HH, Hur H, Jung H, Jeon HM, Park CH, Song KY. Robot-assisted distal gastrectomy for gastric cancer: initial experience. Am J Surg. 2011;201(6):841–5.PubMedCrossRef Lee HH, Hur H, Jung H, Jeon HM, Park CH, Song KY. Robot-assisted distal gastrectomy for gastric cancer: initial experience. Am J Surg. 2011;201(6):841–5.PubMedCrossRef
11.
Zurück zum Zitat Heemskerk J, van Gemert WG, de Vries J, Greve J, Bouvy ND. Learning curves of robot-assisted laparoscopic surgery compared with conventional laparoscopic surgery: an experimental study evaluating skill acquisition of robot-assisted laparoscopic tasks compared with conventional laparoscopic tasks in inexperienced users. Surg Laparosc Endosc Percutan Tech. 2007;17:171–4.PubMedCrossRef Heemskerk J, van Gemert WG, de Vries J, Greve J, Bouvy ND. Learning curves of robot-assisted laparoscopic surgery compared with conventional laparoscopic surgery: an experimental study evaluating skill acquisition of robot-assisted laparoscopic tasks compared with conventional laparoscopic tasks in inexperienced users. Surg Laparosc Endosc Percutan Tech. 2007;17:171–4.PubMedCrossRef
12.
Zurück zum Zitat D’Annibale A, Pende V, Pernazza G, Monsellato I, Mazzocchi P, Lucandri G, et al. Full robotic gastrectomy with extended (D2) lymphadenectomy for gastric cancer: surgical technique and preliminary results. J Surg Res. 2011;166(2):e113–20.PubMedCrossRef D’Annibale A, Pende V, Pernazza G, Monsellato I, Mazzocchi P, Lucandri G, et al. Full robotic gastrectomy with extended (D2) lymphadenectomy for gastric cancer: surgical technique and preliminary results. J Surg Res. 2011;166(2):e113–20.PubMedCrossRef
13.
Zurück zum Zitat Pugliese R, Maggioni D, Sansonna F, Costanzi A, Ferrari GC, Di Lernia S, et al. Subtotal gastrectomy with D2 dissection by minimally invasive surgery for distal adenocarcinoma of the stomach: results and 5-year survival. Surg Endosc. 2010;24(10):2594–602.PubMedCrossRef Pugliese R, Maggioni D, Sansonna F, Costanzi A, Ferrari GC, Di Lernia S, et al. Subtotal gastrectomy with D2 dissection by minimally invasive surgery for distal adenocarcinoma of the stomach: results and 5-year survival. Surg Endosc. 2010;24(10):2594–602.PubMedCrossRef
14.
Zurück zum Zitat Patriti A, Ceccarelli G, Bellochi R, Bartoli A, Spaziani A, Di Zitti L, et al. Robot-assisted laparoscopic total and partial gastric resection with D2 lymph node dissection for adenocarcinoma. Surg Endosc. 2008;22(12):2753–60.PubMedCrossRef Patriti A, Ceccarelli G, Bellochi R, Bartoli A, Spaziani A, Di Zitti L, et al. Robot-assisted laparoscopic total and partial gastric resection with D2 lymph node dissection for adenocarcinoma. Surg Endosc. 2008;22(12):2753–60.PubMedCrossRef
15.
Zurück zum Zitat Pugliese R, Maggioni D, Sansonna F, Ferrari GC, Forgione A, Costanzi A, et al. Outcomes and survival after laparoscopic gastrectomy for adenocarcinoma. Analysis on 65 patients operated on by conventional or robot-assisted minimal access procedures. Eur J Surg Oncol. 2009;35(3):281–8.PubMedCrossRef Pugliese R, Maggioni D, Sansonna F, Ferrari GC, Forgione A, Costanzi A, et al. Outcomes and survival after laparoscopic gastrectomy for adenocarcinoma. Analysis on 65 patients operated on by conventional or robot-assisted minimal access procedures. Eur J Surg Oncol. 2009;35(3):281–8.PubMedCrossRef
16.
Zurück zum Zitat Anderson C, Ellenhorn J, Hellan M, Pigazzi A. Pilot series of robot-assisted laparoscopic subtotal gastrectomy with extended lymphadenectomy for gastric cancer. Surg Endosc. 2007;21(9):1662–6.PubMedCrossRef Anderson C, Ellenhorn J, Hellan M, Pigazzi A. Pilot series of robot-assisted laparoscopic subtotal gastrectomy with extended lymphadenectomy for gastric cancer. Surg Endosc. 2007;21(9):1662–6.PubMedCrossRef
17.
Zurück zum Zitat Kim MC, Heo GU, Jung GJ. Robotic gastrectomy for gastric cancer: surgical techniques and clinical merits. Surg Endosc. 2010;24(3):610–5.PubMedCrossRef Kim MC, Heo GU, Jung GJ. Robotic gastrectomy for gastric cancer: surgical techniques and clinical merits. Surg Endosc. 2010;24(3):610–5.PubMedCrossRef
18.
Zurück zum Zitat Woo Y, Hyung WJ, Pak KH, Inaba K, Obama K, Choi SH et al. Robotic gastrectomy as an oncologically sound alternative to laparoscopic resections for the treatment of early-stage gastric cancers. Arch Surg. 2011;146(9):1086–92. Woo Y, Hyung WJ, Pak KH, Inaba K, Obama K, Choi SH et al. Robotic gastrectomy as an oncologically sound alternative to laparoscopic resections for the treatment of early-stage gastric cancers. Arch Surg. 2011;146(9):1086–92.
19.
Zurück zum Zitat Caruso S, Patriti A, Marrelli D, Ceccarelli G, Ceribelli C, Roviello F, et al. Open vs. robot-assisted laparoscopic gastric resection with D2 lymph node dissection for adenocarcinoma: a case-control study. Int J Med Robot. 2011;7(4):452–8.PubMedCrossRef Caruso S, Patriti A, Marrelli D, Ceccarelli G, Ceribelli C, Roviello F, et al. Open vs. robot-assisted laparoscopic gastric resection with D2 lymph node dissection for adenocarcinoma: a case-control study. Int J Med Robot. 2011;7(4):452–8.PubMedCrossRef
20.
Zurück zum Zitat Yoon HM, Kim YW, Lee JH, Ryu KW, Eom BW, Park JY, et al. Robot-assisted total gastrectomy is comparable with laparoscopically assisted total gastrectomy for early gastric cancer. Surg Endosc. 2012;26(5):1377–81.PubMedCrossRef Yoon HM, Kim YW, Lee JH, Ryu KW, Eom BW, Park JY, et al. Robot-assisted total gastrectomy is comparable with laparoscopically assisted total gastrectomy for early gastric cancer. Surg Endosc. 2012;26(5):1377–81.PubMedCrossRef
21.
Zurück zum Zitat Park JY, Jo MJ, Nam BH, Kim Y, Eom BW, Yoon HM, et al. Surgical stress after robot-assisted distal gastrectomy and its economic implications. Br J Surg. 2012;99(11):1554–61.PubMedCrossRef Park JY, Jo MJ, Nam BH, Kim Y, Eom BW, Yoon HM, et al. Surgical stress after robot-assisted distal gastrectomy and its economic implications. Br J Surg. 2012;99(11):1554–61.PubMedCrossRef
22.
Zurück zum Zitat Hyun MH, Lee CH, Kwon YJ, Cho SI, Jang YJ, Kim DH et al. Robot versus laparoscopic gastrectomy for cancer by an experienced surgeon: comparisons of surgery, complications, and surgical stress. Ann Surg Oncol. 2013;20(4):1258–65. Hyun MH, Lee CH, Kwon YJ, Cho SI, Jang YJ, Kim DH et al. Robot versus laparoscopic gastrectomy for cancer by an experienced surgeon: comparisons of surgery, complications, and surgical stress. Ann Surg Oncol. 2013;20(4):1258–65.
23.
Zurück zum Zitat Sobin L, Gospodarowicz M, Wittekind C. TNM classification of malignant tumors. 7th ed. New York: Wiley-Blackwell; 2009. Sobin L, Gospodarowicz M, Wittekind C. TNM classification of malignant tumors. 7th ed. New York: Wiley-Blackwell; 2009.
24.
Zurück zum Zitat Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011;14(2):113–23.CrossRef Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011;14(2):113–23.CrossRef
25.
Zurück zum Zitat Sano T, Aiko T. New Japanese classifications and treatment guidelines for gastric cancer: revision concepts and major revised points. Gastric Cancer. 2011;14(2):97–100.PubMedCrossRef Sano T, Aiko T. New Japanese classifications and treatment guidelines for gastric cancer: revision concepts and major revised points. Gastric Cancer. 2011;14(2):97–100.PubMedCrossRef
26.
Zurück zum Zitat Hiki N, Fukunaga T, Yamaguchi T, Nunobe S, Tokunaga M, Ohyama S, et al. The benefits of standardizing the operative procedure for the assistant in laparoscopy-assisted gastrectomy for gastric cancer. Langenbecks Arch Surg. 2008;393(6):963–71.PubMedCrossRef Hiki N, Fukunaga T, Yamaguchi T, Nunobe S, Tokunaga M, Ohyama S, et al. The benefits of standardizing the operative procedure for the assistant in laparoscopy-assisted gastrectomy for gastric cancer. Langenbecks Arch Surg. 2008;393(6):963–71.PubMedCrossRef
27.
Zurück zum Zitat Fukunaga T, Hiki N, Tokunaga M, Nohara K, Akashi Y, Katayama H, et al. Left-sided approach for supra-pancreatic lymph node dissection in laparoscopy-assisted distal gastrectomy without duodenal transection. Gastric Cancer. 2009;12(2):106–12.PubMedCrossRef Fukunaga T, Hiki N, Tokunaga M, Nohara K, Akashi Y, Katayama H, et al. Left-sided approach for supra-pancreatic lymph node dissection in laparoscopy-assisted distal gastrectomy without duodenal transection. Gastric Cancer. 2009;12(2):106–12.PubMedCrossRef
28.
Zurück zum Zitat Nunobe S, Hiki N, Fukunaga T, Tokunaga M, Ohyama S, Seto Y, et al. Laparoscopy-assisted pylorus-preserving gastrectomy: preservation of vagus nerve and infrapyloric blood flow induces less stasis. World J Surg. 2007;31(12):2335–40.PubMedCrossRef Nunobe S, Hiki N, Fukunaga T, Tokunaga M, Ohyama S, Seto Y, et al. Laparoscopy-assisted pylorus-preserving gastrectomy: preservation of vagus nerve and infrapyloric blood flow induces less stasis. World J Surg. 2007;31(12):2335–40.PubMedCrossRef
29.
Zurück zum Zitat Tokunaga M, Hiki N, Fukunaga T, Ohyama S, Nunobe S, Yamada K, et al. Is preservation of the celiac branch of the vagal nerve effective in preventing stasis following pylorus-preserving gastrectomy? Hepatogastroenterology. 2011;58(107-108):1046–50.PubMed Tokunaga M, Hiki N, Fukunaga T, Ohyama S, Nunobe S, Yamada K, et al. Is preservation of the celiac branch of the vagal nerve effective in preventing stasis following pylorus-preserving gastrectomy? Hepatogastroenterology. 2011;58(107-108):1046–50.PubMed
30.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.PubMedCentralPubMedCrossRef Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.PubMedCentralPubMedCrossRef
31.
Zurück zum Zitat Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250(2):187–96.PubMedCrossRef Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250(2):187–96.PubMedCrossRef
32.
Zurück zum Zitat Tokunaga M, Kondo J, Tanizawa Y, Bando E, Kawamura T, Terashima M. Postoperative intra-abdominal complications assessed by the Clavien-Dindo classification following open and laparoscopy-assisted distal gastrectomy for early gastric cancer. J Gastrointest Surg. 2012. Tokunaga M, Kondo J, Tanizawa Y, Bando E, Kawamura T, Terashima M. Postoperative intra-abdominal complications assessed by the Clavien-Dindo classification following open and laparoscopy-assisted distal gastrectomy for early gastric cancer. J Gastrointest Surg. 2012.
33.
Zurück zum Zitat Clark J, Sodergren MH, Purkayastha S, Mayer EK, James D, Athanasiou T, et al. The role of robotic assisted laparoscopy for esophagogastric oncological resection; an appraisal of the literature. Dis Esophagus. 2011;24(4):240–50.PubMedCrossRef Clark J, Sodergren MH, Purkayastha S, Mayer EK, James D, Athanasiou T, et al. The role of robotic assisted laparoscopy for esophagogastric oncological resection; an appraisal of the literature. Dis Esophagus. 2011;24(4):240–50.PubMedCrossRef
34.
Zurück zum Zitat Tokunaga M, Hiki N, Fukunaga T, Ogura T, Miyata S, Yamaguchi T. Effect of individual fat areas on early surgical outcomes after open gastrectomy for gastric cancer. Br J Surg. 2009;96(5):496–500.PubMedCrossRef Tokunaga M, Hiki N, Fukunaga T, Ogura T, Miyata S, Yamaguchi T. Effect of individual fat areas on early surgical outcomes after open gastrectomy for gastric cancer. Br J Surg. 2009;96(5):496–500.PubMedCrossRef
35.
Zurück zum Zitat Noshiro H, Shimizu S, Nagai E, Ohuchida K, Tanaka M. Laparoscopy-assisted distal gastrectomy for early gastric cancer: is it beneficial for patients of heavier weight? Ann Surg. 2003;238(5):680–5.PubMedCentralPubMedCrossRef Noshiro H, Shimizu S, Nagai E, Ohuchida K, Tanaka M. Laparoscopy-assisted distal gastrectomy for early gastric cancer: is it beneficial for patients of heavier weight? Ann Surg. 2003;238(5):680–5.PubMedCentralPubMedCrossRef
36.
Zurück zum Zitat Yamada H, Kojima K, Inokuchi M, Kawano T, Sugihara K. Effect of obesity on technical feasibility and postoperative outcomes of laparoscopy-assisted distal gastrectomy: comparison with open distal gastrectomy. J Gastrointest Surg. 2008;12(6):997–1004.PubMedCrossRef Yamada H, Kojima K, Inokuchi M, Kawano T, Sugihara K. Effect of obesity on technical feasibility and postoperative outcomes of laparoscopy-assisted distal gastrectomy: comparison with open distal gastrectomy. J Gastrointest Surg. 2008;12(6):997–1004.PubMedCrossRef
37.
Zurück zum Zitat Makino H, Kunisaki C, Izumisawa Y, Tokuhisa M, Oshima T, Nagano Y, et al. Effect of obesity on laparoscopy-assisted distal gastrectomy compared with open distal gastrectomy for gastric cancer. J Surg Oncol. 2010;102(2):141–7.PubMedCrossRef Makino H, Kunisaki C, Izumisawa Y, Tokuhisa M, Oshima T, Nagano Y, et al. Effect of obesity on laparoscopy-assisted distal gastrectomy compared with open distal gastrectomy for gastric cancer. J Surg Oncol. 2010;102(2):141–7.PubMedCrossRef
38.
Zurück zum Zitat Hiki N, Fukunaga T, Yamaguchi T, Ogura T, Miyata S, Tokunaga M, et al. Increased fat content and body shape have little effect on the accuracy of lymph node retrieval and blood loss in laparoscopic distal gastrectomy for gastric cancer. J Gastrointest Surg. 2009;13(4):626–33.PubMedCrossRef Hiki N, Fukunaga T, Yamaguchi T, Ogura T, Miyata S, Tokunaga M, et al. Increased fat content and body shape have little effect on the accuracy of lymph node retrieval and blood loss in laparoscopic distal gastrectomy for gastric cancer. J Gastrointest Surg. 2009;13(4):626–33.PubMedCrossRef
Metadaten
Titel
Early phase II study of robot-assisted distal gastrectomy with nodal dissection for clinical stage IA gastric cancer
verfasst von
Masanori Tokunaga
Norihiko Sugisawa
Junya Kondo
Yutaka Tanizawa
Etsuro Bando
Taiichi Kawamura
Masanori Terashima
Publikationsdatum
01.07.2014
Verlag
Springer Japan
Erschienen in
Gastric Cancer / Ausgabe 3/2014
Print ISSN: 1436-3291
Elektronische ISSN: 1436-3305
DOI
https://doi.org/10.1007/s10120-013-0293-3

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