Laparoscopic Total Gastrectomy
Authors:
L. Martínek; J. Dostalík; I. Guňka; P. Guňková
Authors‘ workplace:
Katedra chirurgických oborů LF OU v Ostravě, Chirurgická klinika FN Ostrava
přednosta: doc. MUDr. J. Dostalík, CSc.
Published in:
Rozhl. Chir., 2011, roč. 90, č. 7, s. 397-401.
Category:
Monothematic special - Original
Overview
Aim:
Laparoscopic total gastrectomy for cancer have been rarely adopted in Czech Republic. The aim of this study is to assess results of these procedures analyzing our series of patients.
Material and methods:
From May 2002 to June 2010 43 laparoscopic total gastrectomies with lymphadenectomy were performed for patients with gastric cancer. Clinical and tumor parameters, perioperative characteristics, short term and long term results were analyzed retrospectively.
Results:
Males were 27 (63%) and females were 16 (37%). Mean age was 65 years (range 48–80), mean BMI was 25.7 (range 18.7–37.0). 27 patients (63%) had an ASA score III and 16 patients (37%) had an ASA score II. The patologic stage (UICC) was 10 stage I (23%), 10 stage II (23%), 19 stage III (44%) and 4 stage IV (9%). The mean operation time was 292 minutes (range 180–400). Conversion was necessary in four cases (9%) and hand assisted technique was used in four cases (9%). The number of retrieved lymph node were 18 (range 4–32). Five laparoscopic total gastrectomies were estimated as palliative. Median time of hospitalization was 12 days (range 7–86). Overall morbidity was 37%, 5 patients (12%) were died related with postoperative complications. The 3-years overall survival was 50% and 5-years overall survival was 45%.
Conclusion:
Laparoscopic total gastrectomy is feasible and acceptable clinically and oncologically. Surgical skill and patient’s selection are necessary.
Key words:
gastric cancer – laparoscopy
Sources
1. Epidemiologie zhoubných nádorů v České republice [on line]. Epidemiologické analýzy, incidence a mortalita [cit 1.2.2011]. Dostupný z www: http://www.svod.cz/analyse.php?modul=incmor#
2. Šimša, J. Karcinom žaludku, lymfadenektomie a detekce sentinelové uzliny. Jessenius Maxdorf, 2006.
3. Becker, H. D., Hohenberger, W., Junginger, T., Schlag, P. M. Chirurgická onkologie. Grada, 2005.
4. Vrba, R., Neoral, Č., Aujeský, R., Malý, T., Loveček, M. Výsledky chirurgické léčby karcinomu žaludku v období 2004–2008. Rozhl. Chir., 2009, 88, 50–54.
5. Azagra, J. S., Goergen, M., De Simone, P., Ibaňez-Aguirre, J. MInimally invasive surgery for gastric cancer. Surgical Endoscopy, 1999, 13, 351–357.
6. Kitano, S., Shiraishi, N., Uyama, I. Sugihara, K., Tanigawa, N.,and the Japanese Laparoscopic Surgery Study Group A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Annals of Surgery, 2007, 245, 68–72.
7. Kim, H. H., Hyung, W. J., Cho, G. S., Kim, M. Ch., Han, S. U., Kim, W., Ryu, S. W., Lee, H. J., Song, K. Y. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer. Annals of Surgery, 2010, 251, 417–420.
8. Siewert, J. R. Gastric cancer: the dispute between East and West. Gastric Cancer, 2005, 8, 59–61.
9. Goh, P., Kum, C. K. Laparoscopic Billroth II gastrectomy: a review. Surgical Oncology, 1993, 2 (Suppl. 1), 13–18.
10. Novitsky, Y. W., Kercher, K. W., Sing, R. F., Heniford, B. T. Long-term outcomes of laparoscopic resection of gastric gastrointestinal stromal tumors. Annals of Surgery, 2006, 243, 738–745.
11. Kitano, S., Isp, Y., Moriyama, M. Sugimachi, K. Laparoscopic-assisted Billroth I gastrectomy. Surgical Laparoscopy Endoscopy & Percutaneous Techniques, 1994, 4, 146–148.
12. Lee, J. H., Han, H. S. A prospective randomized study comparing open vs laparoscopy-assisted distal gastrectomy in early gastric cancer. Early results. Surgical Endoscopy, 2005, 19, 168–173.
13. Lee, S. I., Choi, Y. S., Park, D. J., Kim, H. H., Yang, H. K., Kim, M. C. Comparative study of laparoscopy-assisted distal gastrectomy and open distal gastrectomy. Journal of the American College of Surgeons, 2006, 202, 874–880.
14. Hwang, S. H., Park, D. J., Jee, Y. S.,Kim, M. Ch., Kim, H. H., Lee, H. J., Yang, H. K., Lee, K. U. Actual 3-Year survival after laparoscopy-assisted gastrectomy for gastric cancer. Archives of Surgery, 2009, 144, 559–564.
15. Gatěk, J., Duben, J., Bakala, J., Miča, T., Dudešek, B., Haša, E., Musil, T., Hnátek, L. Lymfadenektomie u časného karcinomu žaludku. Rozhl. Chir., 2004, 9, 428–438.
16. Vrba, R., Neoral, Č., Aujeský, R., Malý, T., Loveček, M. Výsledky chirurgické léčby karcinomu žaludku v období 2004–2008. Rozhl. Chir., 2009, 88, 50–54.
17. Tesař, J., Krška, Z., Zeman, M. Karcinom žaludku a současnost. Rozhl. Chir., 2010, 89, 169–177.
18. Malý, T., Zonča, T., Neoral, Č., Jurytko, A. Rekonstrukce po gastrektomii. Rozhl. Chir., 2008, 87, 367–375.
19. Pugliese, R., Maggioni, D., Sansona, F., Costanzi, A., Ferrari, G. C., Di Lernia, S., Magistro, C., De Martini, P., Pugliese, F. Subtotal gastrectomy with D2 dissection by minimally invasive surgery for distal adenocarcinoma of the stomach: results and 5-year survival. Surgical Endoscopy, 2009, 24, 2594–2602.
20. Orsenigo, E., Di Palo, S., Tamburini, A., Staudacher, C. Laparoscopy-assisted gastrectomy versus open gastrectomy for gastric cancer: a monoinstitutional Western center experience. Surgical Endoscopy, 2011, 25, 140–145.
21. Huscher, C. G., Mingoli, A., Sgarzini, G., Brachini, G., Binda, B., Di Paola, M., Ponzano, C. Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer: early and long-term results of a 100-patients series. American Journal of Surgery, 2007, 194, 839–844.
22. Kawamura, H., Homma, S., Yokota, R., Watari, H., Hagiwara, M., Sato, M., Noguchi, K., Ueki, S., Kondo, Y. Inspection of safety and accurancy of D2 lymph node dissection in laparoscopic-assisted distal gastrectomy. World Journal of Surgery, 2008, 32, 2366–2370.
23. Zhang, X., Tanigawa, N., Nomura, E., Lee, S. W. Curability of laparoscopic gastrectomy for gastric cancer: an analysis of 10 yearęs experience. Gastric cancer, 2008, 11, 175–180.
24. Lepage, C., Sant, M., Verdecchia, A., Forman, D., Esteve, J., Faivre, J. and the EUROCARE working group Operative mortality after gastric cancer resection and long-term survival differences across Europe. British Journal of Surgery 2010, 97, 235–239.
25. Sierzega, M., Kolodziejczyk, P., Kulig, J. and the Polish Gastric Cancer Study Group Impact of anastomotic leakage on long-term survival after total gastrectomy for carcinoma of the stomach. British Journal of Surgery, 2010, 97, 1035–1042.
26. Hwang, S. H., Kim, H. O., Yoo, Ch., Shin, J. H., Son, B. H. Laparoscopically-assisted distal gastrectomy versus open distal gastrectomy for advanced gastric cancer. Surgical Endoscopy, 2009, 23, 1252–1258.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2011 Issue 7
Most read in this issue
- Antibiotic Prophylaxis in Acute Surgical Procedures – The Current Praxis in Czech Republic
- 750 Satisfied Patients? Stapled Haemorrhoidopexy (Longo Procedure) for the Treatment of Haemorrhoids and Anal Canal Prolapse: A Review of our 10-year Experience
- Arthritis Sternoclavicularis as a Cause of Mediastinitis
- Surgical Management of Perforations during Colonoscopy