Toshiro Tanioka1, Rawat Waratchanont2, Ryosuke Fukuyo3, Toshifumi Saito3, Yuya Umebayashi3, Emi Kanemoto3, Kenta Kobayashi3, Masatoshi Nakagawa3, Mikito Inokuchi3. 1. Department of Gastric Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. t-tanioka.srg1@tmd.ac.jp. 2. Division of General Surgery, Department of Surgery, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand. 3. Department of Gastric Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Abstract
BACKGROUND: Laparoscopic proximal gastrectomy (LPG) is regarded as a less invasive surgery than laparoscopic total gastrectomy (LTG) for early gastric cancer located on the proximal side of the stomach. However, whether LPG is more effective than LTG remains unclear. METHODS: A systematic literature search of studies assessing short-term surgical and nutritional outcomes after LPG and LTG was conducted. A meta-analysis of surgical outcomes (operative time, intraoperative estimated blood loss, postoperative complications, and length of hospital stay) and nutritional outcomes (decrease in body weight, albumin, hemoglobin, total protein, and lymphocyte count) was then performed. All of 11 papers are a retrospective cohort study. RESULTS: Eleven studies reported assessments of the above-mentioned outcomes in 883 patients. There was a trend towards shorter operative time and lower blood loss for LPG compared to LTG though not reaching statistical significance. Other surgical outcomes showed no significant differences. Patients who underwent LTG had a significantly lower body weight (95% confidence interval, 3.01-6.05, [Formula: see text] = 4.53, p < 0.01) and hemoglobin level (95% confidence interval, 1.88-5.87, [Formula: see text] = 3.87, p < 0.01) than patients who underwent LPG at 1 year after surgery. There were no significant differences in other nutritional outcomes. CONCLUSIONS: These results indicate LPG had some advantages in postoperative nutrition. However, no significant differences in short-term surgical outcomes were noted between the two operations. Our analysis suggests that LPG may be more beneficial compared with LTG in terms of perioperative and nutritional outcomes for early-stage gastric cancer.
BACKGROUND: Laparoscopic proximal gastrectomy (LPG) is regarded as a less invasive surgery than laparoscopic total gastrectomy (LTG) for early gastric cancer located on the proximal side of the stomach. However, whether LPG is more effective than LTG remains unclear. METHODS: A systematic literature search of studies assessing short-term surgical and nutritional outcomes after LPG and LTG was conducted. A meta-analysis of surgical outcomes (operative time, intraoperative estimated blood loss, postoperative complications, and length of hospital stay) and nutritional outcomes (decrease in body weight, albumin, hemoglobin, total protein, and lymphocyte count) was then performed. All of 11 papers are a retrospective cohort study. RESULTS: Eleven studies reported assessments of the above-mentioned outcomes in 883 patients. There was a trend towards shorter operative time and lower blood loss for LPG compared to LTG though not reaching statistical significance. Other surgical outcomes showed no significant differences. Patients who underwent LTG had a significantly lower body weight (95% confidence interval, 3.01-6.05, [Formula: see text] = 4.53, p < 0.01) and hemoglobin level (95% confidence interval, 1.88-5.87, [Formula: see text] = 3.87, p < 0.01) than patients who underwent LPG at 1 year after surgery. There were no significant differences in other nutritional outcomes. CONCLUSIONS: These results indicate LPG had some advantages in postoperative nutrition. However, no significant differences in short-term surgical outcomes were noted between the two operations. Our analysis suggests that LPG may be more beneficial compared with LTG in terms of perioperative and nutritional outcomes for early-stage gastric cancer.
Authors: Jessie Steevens; Anita A M Botterweck; Miranda J M Dirx; Piet A van den Brandt; Leo J Schouten Journal: Eur J Gastroenterol Hepatol Date: 2010-06 Impact factor: 2.566
Authors: Nam-Ryong Choi; Min Ha Choi; Chang Seok Ko; Inseob Lee; Chung Sik Gong; Beom Su Kim Journal: Wideochir Inne Tech Maloinwazyjne Date: 2020-04-05 Impact factor: 1.195
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