Feasibility of totally laparoscopic pylorus-preserving gastrectomy with intracorporeal gastro-gastrostomy for early gastric cancer: a retrospective cohort study.
Gastric cancer
Gastro-gastrostomy
Intracorporeal reconstruction
Totally laparoscopic pylorus-preserving gastrectomy
Journal
World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544
Informations de publication
Date de publication:
16 Jul 2020
16 Jul 2020
Historique:
received:
30
01
2020
accepted:
10
07
2020
entrez:
18
7
2020
pubmed:
18
7
2020
medline:
15
5
2021
Statut:
epublish
Résumé
Pylorus-preserving gastrectomy (PPG) has been accepted as a function-preserving surgery for the treatment of early gastric cancer in East Asian countries. Therefore, this study aimed to evaluate the feasibility and safety of totally laparoscopic PPG (TLPPG) with intracorporeal anastomosis. A total of 43 patients with early gastric cancer underwent laparoscopy-assisted PPG (LAPPG) with extracorporeal anastomosis between May 2006 and November 2012. The operative outcomes of 22 patients who underwent TLPPG between November 2012 and February 2019 were evaluated, and data were compared with that of the LAPPG group. No significant difference in the operative time was observed between the two groups. Blood loss was lower in the TLPPG group (18.5 mL) than in the LAPPG group (30.7 mL, p = 0.008), and the length of abdominal incision was shorter in the TLPPG group (3.8 cm) than in the LAPPG group (4.7 cm, p < 0.001). No significant difference in the complication rate was observed between the two groups (13.6% in the TLPPG vs. 9.3% in the LAPPG group, p = 0.594). No anastomosis-related complications occurred in either group. No significant between-group difference was observed in the delayed gastric emptying (TLPPG, 9.1 vs. LAPPG, 7%, p = 0.762). The initiation of postoperative fluid (TLPPG, 1.0 day vs. LAPPG, 3.0 days, p < 0.001) and meal (TLPPG, 3.0 days vs. LAPPG, 4.0 days, p < 0.001) intake was earlier in the TLPPG group than in the LAPPG group. No significant between-group difference was observed in the postoperative hospital stay. The findings of this study suggest that TLPPG with intracorporeal reconstruction not only is as feasible and safe as LAPPG for the treatment of patients with early gastric cancer but also provides certain advantages such as reduced blood loss and wound size.
Sections du résumé
BACKGROUND
BACKGROUND
Pylorus-preserving gastrectomy (PPG) has been accepted as a function-preserving surgery for the treatment of early gastric cancer in East Asian countries. Therefore, this study aimed to evaluate the feasibility and safety of totally laparoscopic PPG (TLPPG) with intracorporeal anastomosis.
METHODS
METHODS
A total of 43 patients with early gastric cancer underwent laparoscopy-assisted PPG (LAPPG) with extracorporeal anastomosis between May 2006 and November 2012. The operative outcomes of 22 patients who underwent TLPPG between November 2012 and February 2019 were evaluated, and data were compared with that of the LAPPG group.
RESULTS
RESULTS
No significant difference in the operative time was observed between the two groups. Blood loss was lower in the TLPPG group (18.5 mL) than in the LAPPG group (30.7 mL, p = 0.008), and the length of abdominal incision was shorter in the TLPPG group (3.8 cm) than in the LAPPG group (4.7 cm, p < 0.001). No significant difference in the complication rate was observed between the two groups (13.6% in the TLPPG vs. 9.3% in the LAPPG group, p = 0.594). No anastomosis-related complications occurred in either group. No significant between-group difference was observed in the delayed gastric emptying (TLPPG, 9.1 vs. LAPPG, 7%, p = 0.762). The initiation of postoperative fluid (TLPPG, 1.0 day vs. LAPPG, 3.0 days, p < 0.001) and meal (TLPPG, 3.0 days vs. LAPPG, 4.0 days, p < 0.001) intake was earlier in the TLPPG group than in the LAPPG group. No significant between-group difference was observed in the postoperative hospital stay.
CONCLUSIONS
CONCLUSIONS
The findings of this study suggest that TLPPG with intracorporeal reconstruction not only is as feasible and safe as LAPPG for the treatment of patients with early gastric cancer but also provides certain advantages such as reduced blood loss and wound size.
Identifiants
pubmed: 32677964
doi: 10.1186/s12957-020-01955-z
pii: 10.1186/s12957-020-01955-z
pmc: PMC7366885
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
170Références
Ann Surg Treat Res. 2015 Oct;89(4):176-82
pubmed: 26446446
Langenbecks Arch Surg. 2016 May;401(3):397-402
pubmed: 26883539
Ann Surg Oncol. 2013 Aug;20(8):2683-92
pubmed: 23504120
Gastric Cancer. 2015 Jan;18(1):183-7
pubmed: 24481853
Ann Surg. 2014 Mar;259(3):485-93
pubmed: 23652333
Br J Surg. 2011 Jun;98(6):845-52
pubmed: 21523699
Ann Surg. 2011 May;253(5):928-33
pubmed: 21358534
Gastric Cancer. 2020 Feb 14;:
pubmed: 32060757
World J Gastroenterol. 2016 Jul 14;22(26):5888-95
pubmed: 27468183
Surg Endosc. 2014 Apr;28(4):1250-5
pubmed: 24232135
Surg Endosc. 2018 Oct;32(10):4337-4343
pubmed: 29785457
Br J Surg. 2008 Sep;95(9):1131-5
pubmed: 18690631
Gastric Cancer. 2015 Apr;18(2):397-406
pubmed: 24760336
Surg Endosc. 2011 Apr;25(4):1076-82
pubmed: 20835726
Gastric Cancer. 2019 May;22(3):423-434
pubmed: 30805742
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
Surg Endosc. 2019 Oct 9;:
pubmed: 31598877
J Gastric Cancer. 2016 Jun;16(2):63-71
pubmed: 27433390
Surg Endosc. 2009 Oct;23(10):2374-9
pubmed: 19263143
Langenbecks Arch Surg. 2017 Feb;402(1):49-56
pubmed: 27815708