BACKGROUND: Very few reports are available on laparoscopic gastrectomy (LG) for advanced gastric cancer (AGC) patients. We therefore conducted a prospective phase II clinical trial to address the feasibility of LG in AGC. Morbidity and mortality were evaluated. METHODS:The eligibility criteria were as follows: 20-80 years of age, cT2N0-cT4aN2, American Society of Anesthesiologists score of 3 or less, and no other malignancy. A total of 204 patients were enrolled onto this study. Of these, 16 were excluded because far-advanced stages of disease were identified after laparoscopic exploration, and 31 were excluded because early gastric cancer was diagnosed postoperatively. All patients underwent a D2 lymphadenectomy. Morbidity was stratified according to the Clavien-Dindo classification. RESULTS: Conversion to open surgery occurred in 11 patients (7.0 %). The mean hospital stay was 6.3 days for distal gastrectomy and 8.5 days for total gastrectomy. The mean number of collected lymph nodes was 52.7 for distal gastrectomy and 63.8 for total gastrectomy. The rates of local and systemic complications of grade II or more were 8.3 and 3.2 %. One patient died of operative complications. In multivariate analysis, old age (>70 years) was an independent risk factor for complications, and old age and Billroth I anastomosis were predictable risk factors for local complications. CONCLUSIONS:LG with D2 lymphadenectomy was safe and technically feasible for the treatment of AGC, with acceptable rate of morbidity and mortality. ClinicalTrial.gov REGISTRATION: NCT01441336.
RCT Entities:
BACKGROUND: Very few reports are available on laparoscopic gastrectomy (LG) for advanced gastric cancer (AGC) patients. We therefore conducted a prospective phase II clinical trial to address the feasibility of LG in AGC. Morbidity and mortality were evaluated. METHODS: The eligibility criteria were as follows: 20-80 years of age, cT2N0-cT4aN2, American Society of Anesthesiologists score of 3 or less, and no other malignancy. A total of 204 patients were enrolled onto this study. Of these, 16 were excluded because far-advanced stages of disease were identified after laparoscopic exploration, and 31 were excluded because early gastric cancer was diagnosed postoperatively. All patients underwent a D2 lymphadenectomy. Morbidity was stratified according to the Clavien-Dindo classification. RESULTS: Conversion to open surgery occurred in 11 patients (7.0 %). The mean hospital stay was 6.3 days for distal gastrectomy and 8.5 days for total gastrectomy. The mean number of collected lymph nodes was 52.7 for distal gastrectomy and 63.8 for total gastrectomy. The rates of local and systemic complications of grade II or more were 8.3 and 3.2 %. One patient died of operative complications. In multivariate analysis, old age (>70 years) was an independent risk factor for complications, and old age and Billroth I anastomosis were predictable risk factors for local complications. CONCLUSIONS: LG with D2 lymphadenectomy was safe and technically feasible for the treatment of AGC, with acceptable rate of morbidity and mortality. ClinicalTrial.gov REGISTRATION: NCT01441336.
Authors: Sang Eok Lee; Keun Won Ryu; Byung Ho Nam; Jun Ho Lee; Young-Woo Kim; Jun Sik Yu; Soo Jeong Cho; Jong Yeul Lee; Chan Gyoo Kim; Il Ju Choi; Myeong Cherl Kook; Sook Ryun Park; Min Ju Kim; Jong Seok Lee Journal: J Surg Oncol Date: 2009-10-01 Impact factor: 3.454
Authors: Yingjun Quan; Ao Huang; Min Ye; Ming Xu; Biao Zhuang; Peng Zhang; Bo Yu; Zhijun Min Journal: Gastric Cancer Date: 2015-07-28 Impact factor: 7.370
Authors: Juan C Rodríguez-Sanjuán; Marcos Gómez-Ruiz; Soledad Trugeda-Carrera; Carlos Manuel-Palazuelos; Antonio López-Useros; Manuel Gómez-Fleitas Journal: World J Gastroenterol Date: 2016-02-14 Impact factor: 5.742