Yan Shi1, Xianhui Xu1, Yongliang Zhao1, Feng Qian1, Bo Tang1, Yingxue Hao1, Huaxing Luo1, Jun Chen1, Peiwu Yu2. 1. Department of General Surgery, Center for Minimally Invasive Gastrointestinal Surgery, Southwest Hospital, Third Military Medical University, No. 30 Gao Tan Yan Road, Chongqing, 400038, China. 2. Department of General Surgery, Center for Minimally Invasive Gastrointestinal Surgery, Southwest Hospital, Third Military Medical University, No. 30 Gao Tan Yan Road, Chongqing, 400038, China. yupeiwu01@sina.com.
Abstract
BACKGROUND:Laparoscopy-assisted gastrectomy (LAG) has gained acceptance as one of the best treatments for early gastric cancer. However, the application of LAG with D2 lymph node dissection in patients with locally advanced gastric cancer (AGC) remains controversial. METHODS: We launched a prospective randomized controlled trial comparing laparoscopic and open gastrectomy with D2 lymph node dissection for locally AGC to evaluate technical safety and oncologic feasibility. The postoperative morbidity and mortality rates were based on the modified intention-to-treat analysis. RESULTS:Between January 2010 and June 2012, a total of 328 patients with preoperative clinical stage T2-3N0-3M0 gastric cancer were enrolled in the trial. Six patients with unresected AGC were excluded, and the remaining 322 patients were randomized to the laparoscopic group (162 patients) or the open group (160 patients) for radical surgery. All patients underwent D2 lymph node dissection including 18 (5.59%) proximal gastrectomies, 196 (60.87%) distal gastrectomies, and 108 (33.54%) total gastrectomies. Six patients (3.70%) in the LAG group were converted to open procedures. The overall complication rate was 11.72% in the LAG group and 14.38% in the open group (P = 0.512). No mortality occurred in either group. CONCLUSIONS: The short-term results of the current study suggest that LAG with D2 lymph node dissection is a safe and feasible procedure in treating patients with locally AGC in experienced centers.
RCT Entities:
BACKGROUND: Laparoscopy-assisted gastrectomy (LAG) has gained acceptance as one of the best treatments for early gastric cancer. However, the application of LAG with D2 lymph node dissection in patients with locally advanced gastric cancer (AGC) remains controversial. METHODS: We launched a prospective randomized controlled trial comparing laparoscopic and open gastrectomy with D2 lymph node dissection for locally AGC to evaluate technical safety and oncologic feasibility. The postoperative morbidity and mortality rates were based on the modified intention-to-treat analysis. RESULTS: Between January 2010 and June 2012, a total of 328 patients with preoperative clinical stage T2-3N0-3M0 gastric cancer were enrolled in the trial. Six patients with unresected AGC were excluded, and the remaining 322 patients were randomized to the laparoscopic group (162 patients) or the open group (160 patients) for radical surgery. All patients underwent D2 lymph node dissection including 18 (5.59%) proximal gastrectomies, 196 (60.87%) distal gastrectomies, and 108 (33.54%) total gastrectomies. Six patients (3.70%) in the LAG group were converted to open procedures. The overall complication rate was 11.72% in the LAG group and 14.38% in the open group (P = 0.512). No mortality occurred in either group. CONCLUSIONS: The short-term results of the current study suggest that LAG with D2 lymph node dissection is a safe and feasible procedure in treating patients with locally AGC in experienced centers.
Authors: Hope T Jackson; Chen-Min S Hung; Deepika Potarazu; Noor Habboosh; Erik J DeAngelis; Richard L Amdur; Jordan M Estroff; Megan T Quintana; Paul Lin; Khashayar Vaziri; Juliet Lee Journal: Surg Endosc Date: 2021-10-19 Impact factor: 3.453
Authors: Philip Wai Yan Chiu; Hon Chi Yip; Anthony Yuen Bun Teoh; Vivien Wai Yin Wong; Shannon Melissa Chan; Simon Kin Hung Wong; Enders Kwok Wai Ng Journal: Surg Endosc Date: 2019-01-02 Impact factor: 4.584