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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2015

01-12-2015 | Gastrointestinal Oncology

Feasibility and Nutritional Benefits of Laparoscopic Proximal Gastrectomy for Early Gastric Cancer in the Upper Stomach

Authors: Toshiyuki Kosuga, MD, PhD, Daisuke Ichikawa, MD, PhD, Shuhei Komatsu, MD, PhD, Kazuma Okamoto, MD, PhD, Hirotaka Konishi, MD, PhD, Atsushi Shiozaki, MD, PhD, Hitoshi Fujiwara, MD, PhD, Eigo Otsuji, MD, PhD

Published in: Annals of Surgical Oncology | Special Issue 3/2015

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Abstract

Background

Laparoscopic proximal gastrectomy (LPG) has recently been applied for early gastric cancer (EGC) in the upper stomach as a minimally invasive and function-preserving surgery. This study aimed to clarify the feasibility and nutritional benefits of LPG over laparoscopic total gastrectomy (LTG).

Methods

This was a retrospective study of 77 patients with clinical stage I gastric cancer in the upper stomach. Of these patients, 25 underwent LPG, while 52 underwent LTG. Surgical outcomes and postoperative nutritional status such as changes in body weight and blood chemistries were compared between LPG and LTG.

Results

Intraoperative blood loss and C-reactive protein levels at 3 and 7 days after surgery were significantly lower in LPG than in LTG (p = 0.018, 0.036, and 0.042, respectively). No significant differences were observed in postoperative early or late complication rates between LPG and LTG. The incidence of Los Angeles Grade B or more severe reflux esophagitis after LPG was 9.1 %, which was similar to that after LTG (9.3 %). Postoperative changes in body weight at 6 months and 1 and 2 years after surgery were consistently less in LPG than in LTG (p = 0.001, 0.022, and 0.001, respectively). Moreover, postoperative levels of hemoglobin and serum albumin and total lymphocyte count were also higher in LPG than in LTG.

Conclusion

LPG may be a better choice for EGC in the upper stomach than LTG because it has distinct advantages in terms of surgical invasiveness and postoperative nutritional status.
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Metadata
Title
Feasibility and Nutritional Benefits of Laparoscopic Proximal Gastrectomy for Early Gastric Cancer in the Upper Stomach
Authors
Toshiyuki Kosuga, MD, PhD
Daisuke Ichikawa, MD, PhD
Shuhei Komatsu, MD, PhD
Kazuma Okamoto, MD, PhD
Hirotaka Konishi, MD, PhD
Atsushi Shiozaki, MD, PhD
Hitoshi Fujiwara, MD, PhD
Eigo Otsuji, MD, PhD
Publication date
01-12-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue Special Issue 3/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4590-4

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