Published in:
01-02-2020 | Esophagojejunostomy | ASO Author Reflections
ASO Author Reflections: Anastomotic Complications are More Prevalent in Laparoscopic Total Gastrectomy than in Open Total Gastrectomy
Authors:
Takashi Sakamoto, MD, MPH, Michimasa Fujiogi, MD, Hiroki Matsui, MPH, Kiyohide Fushimi, MD, Hideo Yasunaga, MD
Published in:
Annals of Surgical Oncology
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Issue 2/2020
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Excerpt
The first laparoscopic gastrectomy for gastric cancer was performed in 1991.
1 Since then, a laparoscopic approach for gastric cancer has become widespread, although sufficient evidence for the safety regarding short-term outcomes is lacking. Laparoscopic distal gastrectomy (LDG) has proved to be safe in some studies, including a nationwide large-sample study.
2 Laparoscopic total gastrectomy (LTG) is more difficult than LDG, partly because laparoscopic esophagojejunostomy is technically demanding. Most previous studies have demonstrated similar mortality and morbidity between LTG and open total gastrectomy (OTG), concluding that LTG is a safe procedure. However, these studies have shown relatively high proportions of anastomotic leakage after LTG compared with OTG.
3,
4 But LTG also is reported to have the advantages of a shorter postoperative stay and smaller blood loss volumes.
4 However, all these reports had limited generalizability because of their single-center (or low numbers of centers) design. Analysis of data from different hospitals showing varied experiences with LTG and OTG is lacking. …
