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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2014

01-06-2014 | Gastrointestinal Oncology

Randomized Comparison of Surgical Stress and the Nutritional Status Between Laparoscopy-Assisted and Open Distal Gastrectomy for Gastric Cancer

Authors: Toru Aoyama, MD, Takaki Yoshikawa, MD, PhD, Tsutomu Hayashi, MD, Shinichi Hasegawa, MD, Kazuhito Tsuchida, MD, Takanobu Yamada, MD, Haruhiko Cho, MD, Takashi Ogata, MD, PhD, Hirohito Fujikawa, MD, Norio Yukawa, MD, Takashi Oshima, MD, PhD, Yasushi Rino, MD, Munetaka Masuda, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2014

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Abstract

Background

Laparoscopy-assisted distal gastrectomy (LADG) for gastric cancer may prevent the development of an impaired nutritional status due to reduced surgical stress compared with open distal gastrectomy (ODG).

Methods

This study was performed as an exploratory analysis of a phase III trial comparing LADG and ODG for stage I gastric cancer during the period between May and December of 2011. All patients received the same perioperative care via fast-track surgery. The level of surgical stress was evaluated based on the white blood cell count and the interleukin-6 (IL-6) level. The nutritional status was measured according to the total body weight, amount of lean body mass, lymphocyte count, and prealbumin level.

Results

Twenty-six patients were randomized to receive ODG (13 patients) or LADG (13 patients). The baseline characteristics and surgical outcomes were similar between the two groups. The median IL-6 level increased from 0.8 to 36.3 pg/dl in the ODG group and from 1.5 to 53.3 pg/dl in the LADG group. The median amount of lean body mass decreased from 48.3 to 46.8 kg in the ODG group and from 46.6 to 46.0 kg in the LADG group. There are no significant differences between two groups.

Conclusions

The level of surgical stress and the nutritional status were found to be similar between the ODG and LADG groups in a randomized comparison using the same perioperative care of fast-track surgery.
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Metadata
Title
Randomized Comparison of Surgical Stress and the Nutritional Status Between Laparoscopy-Assisted and Open Distal Gastrectomy for Gastric Cancer
Authors
Toru Aoyama, MD
Takaki Yoshikawa, MD, PhD
Tsutomu Hayashi, MD
Shinichi Hasegawa, MD
Kazuhito Tsuchida, MD
Takanobu Yamada, MD
Haruhiko Cho, MD
Takashi Ogata, MD, PhD
Hirohito Fujikawa, MD
Norio Yukawa, MD
Takashi Oshima, MD, PhD
Yasushi Rino, MD
Munetaka Masuda, MD, PhD
Publication date
01-06-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 6/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3509-9

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