Laparoscopic Versus Open Gastrectomy for Cancer: A Western Center Cohort Study

Andrianos Tsekrekos*, Fredrik Klevebro, Masaru Hayami, Satoshi Kamiya, Mats Lindblad, Magnus Nilsson, Lars Lundell, Ioannis Rouvelas

*Kontaktforfatter for dette arbejde

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    Resumé

    Background: Laparoscopic gastrectomy (LG) for cancer has been introduced in institutions worldwide in an effort to minimize surgical trauma, while aiming to provide comparable oncological outcomes to conventional open gastrectomy (OG). The aim of this study was to present our results during the period of implementation of the laparoscopic technique. Materials and methods: In 2012, LG for the treatment of gastric cancer was introduced at our institution. The results presented are based on a retrospective analysis of data from a cohort of all patients treated with curative intent over the period 2010-2018. Results: During the study period, 206 patients underwent surgery for gastric cancer: 129 patients (62.6%) had an OG and 77 patients (37.4%) an LG. The conversion rate due to technical reasons was 2.6%. LG was associated with significantly less intraoperative blood loss [mean (mL), OG 544 versus LG 176] and shorter hospital stay than OG [mean (d), OG 12 versus LG 8], fewer severe complications (Clavien-Dindo grade ≥ IIIb) [OG 29 (22.5%) versus LG 9 (11.7%), P = 0.081], significantly lower anastomotic leak rate [OG 18 (14.0%) versus LG 1 (1.3%)] and no 90-day mortality. The percentage of R0 resections was similar between the two groups (OG 82.2% versus LG 85.7%, P = 0.507), while the mean number of resected lymph nodes was significantly higher in the laparoscopic group [OG 34 versus LG 39, P = 0.030]. Conclusions: Our data suggest that similar and, in some aspects, better short-term outcomes can be achieved with LG with maintained oncological quality.

    OriginalsprogEngelsk
    TidsskriftJournal of Surgical Research
    ISSN0022-4804
    DOI
    StatusE-pub ahead of print - 31. okt. 2019

    Fingeraftryk

    Gastrectomy
    Cohort Studies
    Neoplasms
    Anastomotic Leak

    Citer dette

    Tsekrekos, A., Klevebro, F., Hayami, M., Kamiya, S., Lindblad, M., Nilsson, M., ... Rouvelas, I. (2019). Laparoscopic Versus Open Gastrectomy for Cancer: A Western Center Cohort Study. Journal of Surgical Research. https://doi.org/10.1016/j.jss.2019.10.006
    Tsekrekos, Andrianos ; Klevebro, Fredrik ; Hayami, Masaru ; Kamiya, Satoshi ; Lindblad, Mats ; Nilsson, Magnus ; Lundell, Lars ; Rouvelas, Ioannis. / Laparoscopic Versus Open Gastrectomy for Cancer : A Western Center Cohort Study. I: Journal of Surgical Research. 2019.
    @article{561d8d9afbcb4e278ccf18080028e6b3,
    title = "Laparoscopic Versus Open Gastrectomy for Cancer: A Western Center Cohort Study",
    abstract = "Background: Laparoscopic gastrectomy (LG) for cancer has been introduced in institutions worldwide in an effort to minimize surgical trauma, while aiming to provide comparable oncological outcomes to conventional open gastrectomy (OG). The aim of this study was to present our results during the period of implementation of the laparoscopic technique. Materials and methods: In 2012, LG for the treatment of gastric cancer was introduced at our institution. The results presented are based on a retrospective analysis of data from a cohort of all patients treated with curative intent over the period 2010-2018. Results: During the study period, 206 patients underwent surgery for gastric cancer: 129 patients (62.6{\%}) had an OG and 77 patients (37.4{\%}) an LG. The conversion rate due to technical reasons was 2.6{\%}. LG was associated with significantly less intraoperative blood loss [mean (mL), OG 544 versus LG 176] and shorter hospital stay than OG [mean (d), OG 12 versus LG 8], fewer severe complications (Clavien-Dindo grade ≥ IIIb) [OG 29 (22.5{\%}) versus LG 9 (11.7{\%}), P = 0.081], significantly lower anastomotic leak rate [OG 18 (14.0{\%}) versus LG 1 (1.3{\%})] and no 90-day mortality. The percentage of R0 resections was similar between the two groups (OG 82.2{\%} versus LG 85.7{\%}, P = 0.507), while the mean number of resected lymph nodes was significantly higher in the laparoscopic group [OG 34 versus LG 39, P = 0.030]. Conclusions: Our data suggest that similar and, in some aspects, better short-term outcomes can be achieved with LG with maintained oncological quality.",
    keywords = "Gastric cancer, Laparoscopic gastrectomy, Surgical outcomes",
    author = "Andrianos Tsekrekos and Fredrik Klevebro and Masaru Hayami and Satoshi Kamiya and Mats Lindblad and Magnus Nilsson and Lars Lundell and Ioannis Rouvelas",
    year = "2019",
    month = "10",
    day = "31",
    doi = "10.1016/j.jss.2019.10.006",
    language = "English",
    journal = "Journal of Surgical Research",
    issn = "0022-4804",
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    Laparoscopic Versus Open Gastrectomy for Cancer : A Western Center Cohort Study. / Tsekrekos, Andrianos; Klevebro, Fredrik; Hayami, Masaru; Kamiya, Satoshi; Lindblad, Mats; Nilsson, Magnus; Lundell, Lars; Rouvelas, Ioannis.

    I: Journal of Surgical Research, 31.10.2019.

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    TY - JOUR

    T1 - Laparoscopic Versus Open Gastrectomy for Cancer

    T2 - A Western Center Cohort Study

    AU - Tsekrekos, Andrianos

    AU - Klevebro, Fredrik

    AU - Hayami, Masaru

    AU - Kamiya, Satoshi

    AU - Lindblad, Mats

    AU - Nilsson, Magnus

    AU - Lundell, Lars

    AU - Rouvelas, Ioannis

    PY - 2019/10/31

    Y1 - 2019/10/31

    N2 - Background: Laparoscopic gastrectomy (LG) for cancer has been introduced in institutions worldwide in an effort to minimize surgical trauma, while aiming to provide comparable oncological outcomes to conventional open gastrectomy (OG). The aim of this study was to present our results during the period of implementation of the laparoscopic technique. Materials and methods: In 2012, LG for the treatment of gastric cancer was introduced at our institution. The results presented are based on a retrospective analysis of data from a cohort of all patients treated with curative intent over the period 2010-2018. Results: During the study period, 206 patients underwent surgery for gastric cancer: 129 patients (62.6%) had an OG and 77 patients (37.4%) an LG. The conversion rate due to technical reasons was 2.6%. LG was associated with significantly less intraoperative blood loss [mean (mL), OG 544 versus LG 176] and shorter hospital stay than OG [mean (d), OG 12 versus LG 8], fewer severe complications (Clavien-Dindo grade ≥ IIIb) [OG 29 (22.5%) versus LG 9 (11.7%), P = 0.081], significantly lower anastomotic leak rate [OG 18 (14.0%) versus LG 1 (1.3%)] and no 90-day mortality. The percentage of R0 resections was similar between the two groups (OG 82.2% versus LG 85.7%, P = 0.507), while the mean number of resected lymph nodes was significantly higher in the laparoscopic group [OG 34 versus LG 39, P = 0.030]. Conclusions: Our data suggest that similar and, in some aspects, better short-term outcomes can be achieved with LG with maintained oncological quality.

    AB - Background: Laparoscopic gastrectomy (LG) for cancer has been introduced in institutions worldwide in an effort to minimize surgical trauma, while aiming to provide comparable oncological outcomes to conventional open gastrectomy (OG). The aim of this study was to present our results during the period of implementation of the laparoscopic technique. Materials and methods: In 2012, LG for the treatment of gastric cancer was introduced at our institution. The results presented are based on a retrospective analysis of data from a cohort of all patients treated with curative intent over the period 2010-2018. Results: During the study period, 206 patients underwent surgery for gastric cancer: 129 patients (62.6%) had an OG and 77 patients (37.4%) an LG. The conversion rate due to technical reasons was 2.6%. LG was associated with significantly less intraoperative blood loss [mean (mL), OG 544 versus LG 176] and shorter hospital stay than OG [mean (d), OG 12 versus LG 8], fewer severe complications (Clavien-Dindo grade ≥ IIIb) [OG 29 (22.5%) versus LG 9 (11.7%), P = 0.081], significantly lower anastomotic leak rate [OG 18 (14.0%) versus LG 1 (1.3%)] and no 90-day mortality. The percentage of R0 resections was similar between the two groups (OG 82.2% versus LG 85.7%, P = 0.507), while the mean number of resected lymph nodes was significantly higher in the laparoscopic group [OG 34 versus LG 39, P = 0.030]. Conclusions: Our data suggest that similar and, in some aspects, better short-term outcomes can be achieved with LG with maintained oncological quality.

    KW - Gastric cancer

    KW - Laparoscopic gastrectomy

    KW - Surgical outcomes

    U2 - 10.1016/j.jss.2019.10.006

    DO - 10.1016/j.jss.2019.10.006

    M3 - Journal article

    C2 - 31679797

    AN - SCOPUS:85074170762

    JO - Journal of Surgical Research

    JF - Journal of Surgical Research

    SN - 0022-4804

    ER -