Evaluation of the Safety and Feasibility of Laparoscopic Total Gastrectomy in Clinical Stage I Gastric Cancer Patients
In: World Journal of Surgery, Jg. 39 (2015-02-10), S. 1782-1788
Online
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Zugriff:
This retrospective study was designed to assess the feasibility of laparoscopic total gastrectomy (LTG) in clinical stage I gastric cancer patients, and validate the appropriateness of the widespread adoption of LTG for experienced open surgeons. Eighty-eight patients with clinical stage I gastric cancer underwent LTG in our hospitals (n = 55) and affiliated hospitals (n = 33). Esophagojejunostomy was performed intracoporeally using a circular stapler with an incision in the left upper abdomen. We investigated the patients’ clinicopathologic factor, and evaluated the effect of hospital volume on short-term outcomes. Fixed insertion of the anvil head was successfully achieved in all patients (lift-up method in 58 patients and transoral method in 28 patients), although 2 patients were converted to open surgery. The approach using a circular stapler through a small incision from the upper left quadrant of the abdomen facilitated a good laparoscopic visual field for the plane of the esophagojejunostomy. Fourteen patients developed Clavien–Dindo classification grade II or more postoperative complications, and the overall operative morbidity rate was 15.9 %. No anastomotic leakage was encountered in this series. No significant difference was observed in clinical outcomes between patients in the high- and low-volume hospital groups. Laparoscopic total gastrectomy can be performed safely on clinical stage I gastric cancer patients by surgeons with sufficient experience in open gastrectomy and therefore represents a feasible procedure that is not clinically impacted by hospital volume.
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Evaluation of the Safety and Feasibility of Laparoscopic Total Gastrectomy in Clinical Stage I Gastric Cancer Patients
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Autor/in / Beteiligte Person: | Otsuji, Eigo ; Kubota, Takeshi ; Okamoto, Kazuma ; Ichikawa, Daisuke ; Konishi, Hirotaka ; Komatsu, Shuhei ; Shiozaki, Atsushi ; Fujiwara, Hitoshi |
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Zeitschrift: | World Journal of Surgery, Jg. 39 (2015-02-10), S. 1782-1788 |
Veröffentlichung: | Springer Science and Business Media LLC, 2015 |
Medientyp: | unknown |
ISSN: | 1432-2323 (print) ; 0364-2313 (print) |
DOI: | 10.1007/s00268-015-3008-6 |
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