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World Journal of Surgical Oncology

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Open Access 01-12-2016 | Research

Totally laparoscopic versus laparoscopic-assisted total gastrectomy for upper and middle gastric cancer: a single-unit experience of 253 cases with meta-analysis

Authors: Ke Chen, Yu Pan, Jia-Qin Cai, Di Wu, Jia-Fei Yan, Ding-Wei Chen, Hong-Mei Yu, Xian-Fa Wang

Published in: World Journal of Surgical Oncology | Issue 1/2016

Abstract

Background

Laparoscopic-assisted total gastrectomy (LATG) is the most commonly used methods of laparoscopic gastrectomy for upper and middle gastric cancer. However, totally laparoscopic total gastrectomy (TLTG) is unpopular because reconstruction is difficult, especially for the intracorporeal esophagojejunostomy. We adopted TLTG with various types of intracorporeal esophagojejunostomy. In this study, we compared LATG and TLTG to evaluate their outcomes.

Methods

From March 2006 to September 2015, 253 patients with upper and middle gastric cancer underwent laparoscopic total gastrectomy (LTG), 145 patients underwent LATG, and 108 patients underwent TLTG. The clinicopathological characteristics and postoperative outcomes were retrospectively compared between the two groups. Furthermore, a systematic review and meta-analysis were conducted.

Results

The operation time and estimated blood loss were similar between the groups. There were no significant differences in first flatus, diet initiation, and postoperative hospital stay. The surgical complication rates were 17.2 % (25/145) and 13.9 % (15/108) in the LATG and TLTG groups, respectively. The meta-analysis also revealed no significant differences in the operation time, estimated blood loss, time to first flatus, length of hospital stay, overall, and anastomosis-related complications among the groups.

Conclusions

TLTG is a feasible choice for gastric cancer patients, with comparable results to the LATG approach.

World Health Organization, International Agency for Research on Cancer (2008) GLOBOCAN 2008: cancer incidence and mortality worldwide 2008. http://globocan.iarc.fr/. Accessed 18 March 2013

Kitano S, Shiraishi N, Uyama I, et al. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007;245:68–72.CrossRefPubMedPubMedCentral

Ikeda O, Sakaguchi Y, Aoki Y, Harimoto N, Taomoto J, Masuda T, Ohga T, Adachi , Toh, Okamura, Baba. Advantages of totally laparoscopic distal gastrectomy over laparoscopically assisted distal gastrectomy for gastric cancer. Surg Endosc. 2009;23:2374–9.

Guzman EA, Pigazzi A, Lee B, Soriano PA, Nelson RA, Benjamin Paz I, Trisal V, Kim J, Ellenhorn JD. Totally laparoscopic gastric resection with extended lymphadenectomy for gastric adenocarcinoma. Ann Surg Oncol. 2009;16:2218–23.CrossRefPubMed

Song KY, Park CH, Kang HC, Kim JJ, Park SM, Jun KH, Chin HM, Hur H. Is totally laparoscopic gastrectomy less invasive than laparoscopy-assisted gastrectomy? Prospective, multicenter study. J Gastrointest Surg. 2008;12:1015–21.CrossRefPubMed

Huscher CG, Mingoli A, Sgarzini G, Brachini G, Binda B, Di Paola M, Ponzano C. Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer: early and long-term results of a 100-patient series. Am J Surg. 2007;194:839–44. discussion 844.CrossRefPubMed

Chen K, Xu X, Mou Y, Pan Y, Zhang R, Zhou Y, Wu, Huang C. Totally laparoscopic distal gastrectomy with D₂ lymphadenectomy and Billroth II gastrojejunostomy for gastric cancer: short- and medium-term results of 139 consecutive cases from a single institution. Int J Med Sci. 2013;10:1462–70.

Chen K, Mou YP, Xu XW, Cai JQ, Wu D, Pan Y, Zhang RC. Short-term surgical and long-term survival outcomes after laparoscopic distal gastrectomy with D₂ lymphadenectomy for gastric cancer. BMC Gastroenterol. 2014;14:41.CrossRefPubMedPubMedCentral

Chen K, Mou YP, Xu XW, Pan Y, Zhou YC, Cai JQ, Huang CJ. Comparison of short-term surgical outcomes between totally laparoscopic and laparoscopic-assisted distal gastrectomy for gastric cancer: a 10-y single-center experience with meta-analysis. J Surg Res. 2015;194:367–74.CrossRefPubMed

10.

Cai J, Mou YP, Pan Y, Chen K, Xu XW, Zhou Y. Immunoglobulin G4-associated cholangitis mimicking cholangiocarcinoma treated by laparoscopic choledochectomy with intracorporeal Roux-en-Y hepaticojejunostomy. World J Surg Oncol. 2014;12:363.CrossRefPubMedPubMedCentral

11.

Cai JQ, Chen K, Mou YP, Pan Y, Xu XW, Zhou YC, Huang CJ. Laparoscopic versus open wedge resection for gastrointestinal stromal tumors of the stomach: a single-center 8-year retrospective cohort study of 156 patients with long-term follow-up. BMC Surg. 2015;15:58.CrossRefPubMedPubMedCentral

12.

Pan Y, Mou YP, Chen K, Xu XW, Cai JQ, Wu D, Zhou YC. Three cases of laparoscopic total gastrectomy with intracorporeal esophagojejunostomy for gastric cancer in remnant stomach. World J Surg Oncol. 2014;12:342.CrossRefPubMedPubMedCentral

13.

Yan JF, Xu XW, Jin WW, Huang CJ, Chen K, Zhang RC, Harsha A, Mou YP. Laparoscopic spleen-preserving distal pancreatectomy for pancreatic neoplasms: a retrospective study. World J Gastroenterol. 2014;20:13966–72.CrossRefPubMedPubMedCentral

14.

Ajoodhea H, Zhang RC, Xu XW, Jin WW, Chen K, He YT, Mou YP: Intracorporeal esophagojejunostomy after totally laparoscopic total gastrectomy: a single-center 7-year experience. World J Gastroenterol 2016, 22 (online)

15.

Kim HS, Kim MG, Kim BS, Lee IS, Lee S, Yook JH, Kim BS. Comparison of totally laparoscopic total gastrectomy and laparoscopic-assisted total gastrectomy methods for the surgical treatment of early gastric cancer near the gastroesophageal junction. J Laparoendosc Adv Surg Tech A. 2013;23:204–10.CrossRefPubMed

16.

Jung YJ, Kim DJ, Lee JH, Kim W. Safety of intracorporeal circular stapling esophagojejunostomy using trans-orally inserted anvil (OrVil) following laparoscopic total or proximal gastrectomy—comparison with extracorporeal anastomosis. World J Surg Oncol. 2013;11:209.CrossRefPubMedPubMedCentral

17.

Ito H, Inoue H, Odaka N, Satodate H, Onimaru M, Ikeda H, Takayanagi D, Nakahara K, Kudo SE. Evaluation of the safety and efficacy of esophagojejunostomy after totally laparoscopic total gastrectomy using a trans-orally inserted anvil: a single-center comparative study. Surg Endosc. 2014;28:1929–35.CrossRefPubMed

18.

Kim HS, Kim BS, Lee S, Lee IS, Yook JH, Kim BS. Reconstruction of esophagojejunostomies using endoscopic linear staplers in totally laparoscopic total gastrectomy: report of 139 cases in a large-volume center. Surg Laparosc Endosc Percutan Tech. 2013;23:e209–16.CrossRefPubMed

19.

Takiguchi S, Sekimoto M, Fujiwara Y, Miyata H, Yasuda T, Doki Y, Yano M, Monden M. A simple technique for performing laparoscopic purse-string suturing during circular stapling anastomosis. Surg Today. 2005;35:896–9.CrossRefPubMed

20.

Usui S, Nagai K, Hiranuma S, Takiguchi N, Matsumoto A, Sanada K. Laparoscopy-assisted esophagoenteral anastomosis using endoscopic purse-string suture instrument “Endo-PSI (II)” and circular stapler. Gastric Cancer. 2008;11:233–7.CrossRefPubMed

21.

Omori T, Oyama T, Mizutani S, Tori M, Nakajima K, Akamatsu H, Nakahara M, Nishida T. A simple and safe technique for esophagojejunostomy using the hemidouble stapling technique in laparoscopy-assisted total gastrectomy. Am J Surg. 2009;197:e13–7.CrossRefPubMed

22.

Jeong O, Park YK. Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil) after laparoscopic total gastrectomy. Surg Endosc. 2009;23:2624–30.CrossRefPubMed

23.

Wang ZQ, Cai ZM, Chen J, Lei X, Luo HX, Yu PW. A modified method of laparoscopic side-to-side esophagojejunal anastomosis: report of 14 cases. Surg Endosc. 2008;22:2091–4.CrossRef

Title: Totally laparoscopic versus laparoscopic-assisted total gastrectomy for upper and middle gastric cancer: a single-unit experience of 253 cases with meta-analysis
Authors: Ke Chen
Yu Pan
Jia-Qin Cai
Di Wu
Jia-Fei Yan
Ding-Wei Chen
Hong-Mei Yu
Xian-Fa Wang
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2016
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-016-0860-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Totally laparoscopic versus laparoscopic-assisted total gastrectomy for upper and middle gastric cancer: a single-unit experience of 253 cases with meta-analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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