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Published in: Surgery Today 10/2020

01-10-2020 | Gastrectomy | Original Article

Influence of endoscopic resection on additional laparoscopic distal gastrectomy: a propensity score-matching analysis

Authors: Koji Shindo, Jaymel Castillo, Kenoki Ohuchida, Taiki Moriyama, Shuntaro Nagai, Tomohiko Moriyama, Takao Ohtsuka, Eishi Nagai, Shuji Shimizu, Masufumi Nakamura

Published in: Surgery Today | Issue 10/2020

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Abstract

Purpose

There is no definite evidence of the feasibility and safety of laparoscopic distal gastrectomy (LDG) for patients who have undergone incomplete endoscopic resection (ER). We investigated the influence of ER prior to LDG by a propensity score matching analysis.

Methods

We retrospectively analyzed the outcomes of gastric cancer patients who underwent LDG with or without prior ER from 2000 to 2014. Propensity score matching was performed to compare the two groups of patients.

Results

After matching, 47 patients in the ER group and 94 patients in the non-ER group were selected from a total of 365 patients. A residual tumor was observed in 10 of 47 patients (21.3%). The mean number of dissected lymph nodes in the non-ER group (39.4 ± 14.5) was higher than that in the ER group (31.7 ± 13.5) (P = 0.003). However, other perioperative data, such as the operation time and blood loss volume were similar. The complication rate of the ER group (17.0%) and the non-ER group (9.6%) did not differ to a statistically significant extent (P = 0.2). Among these patients, 6 died during the 5-year follow-up period, but no patients showed signs of recurrence.

Conclusion

ER prior to surgical resection showed no significant influence on postoperative complications or mortality. LDG can be safely performed to achieve radical resection after incomplete ER.
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Metadata
Title
Influence of endoscopic resection on additional laparoscopic distal gastrectomy: a propensity score-matching analysis
Authors
Koji Shindo
Jaymel Castillo
Kenoki Ohuchida
Taiki Moriyama
Shuntaro Nagai
Tomohiko Moriyama
Takao Ohtsuka
Eishi Nagai
Shuji Shimizu
Masufumi Nakamura
Publication date
01-10-2020
Publisher
Springer Singapore
Published in
Surgery Today / Issue 10/2020
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-020-02012-8

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