Clinical Research Papers:
Oncologic effectiveness of laparoscopic total gastrectomy for remnant gastric cancer: a casecontrol study and comprehensive review
Jun Lu1,2,3,4, Xintao Yang1,2 , Chaohui Zheng1,2,3,4, Ping Li1,2,3,4, Jiawei Xie1,2,3,4, Jiabin Wang1,2,3,4, Jianxian Lin1,2,3,4, and Changming Huang1,2,3,4
1Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China
2Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
3Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
4Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
Correspondence to:
Changming Huang, email: [email protected]
Chaohui Zheng, email: [email protected]
Keywords: remnant gastric cancer; laparoscopic; total gastrectomy; survival
Received: April 27, 2017 Accepted: February 23, 2018 Published:
ABSTRACT
Background: Complete total gastrectomy for remnant gastric cancer is challenging, especially using the laparoscopic approach, and the benefits of laparoscopic surgery to treat remnant gastric cancer are unclear.
Methods: Retrospective data from 69 remnant gastric cancer patients who received total gastrectomies from Dec 2007 to Apr 2014 were reviewed. We compared clinicopathological data, intraoperative factors, postoperative outcomes, and survival between laparoscopic and open surgery groups.
Results: Thirty-four patients received laparoscopic total gastrectomy, and 35 patients underwent open surgery. There was no statistical disparity in clinicopathological parameters between the two cohorts. Perioperative characteristics, including blood loss (p = 0.002), operation time (p < 0.001) and postoperative hospital stay (p = 0.012), were significantly lower in the laparoscopic group than in the open surgery group, and a greater number of dissected lymph nodes were obtained (p = 0.048). No significant differences were observed in either the time to first flatus or the rate of severe complications. The difference in 5-year cumulative survival rates was 45.31% for the open group and 37.96% for the laparoscopic group, which was not statistically significant (p = 0.957). The survival time was not significantly different between the laparoscopic and open groups for either stage I+II or the stage III subgroups (p = 0.542 and p = 0.774, respectively.
Conclusion: With better short-term surgical efficacy, the long-term survival outcomes using laparoscopic total gastrectomy to treat remnant gastric cancer were comparable to those of open gastrectomy. Thus, a minimally invasive approach is a potential option for treating remnant gastric cancer patients.