JCT  Vol.4 No.1 A , January 2013
Safety and Efficacy of Laparoscopy-Assisted Gastrectomy after Endoscopic Submucosal Dissection for Early Gastric Cancer: A Retrospective Report
ABSTRACT

Background: This study aimed to determine the safety and effectiveness of laparoscopy-assisted distal gastrectomy (LADG) after ESD. Methods: We reviewed patients with gastric cancer who underwent distal gastrectomy after non-curative ESD from May 2000 to July 2010, and classified them into LADG-ESD and open distal gastrectomy (ODG) after non-curative ESD (ODG-ESD). In addition, we analyzed the standard LADG (LADG-standard) during the same period. We retrospectively analyzed surgical outcomes and survival in these 3 groups. Pathological results after gastrectomy were compared between the LADG-ESD and ODG-ESD; Results: Sixty-one patients underwent distal gastrectomy after non-curative ESD. No differences in overall survival were found between the LADG-ESD and ODG-ESD. The average duration to surgery after ESD was 42.4 days. Although the average surgical duration and average length of hospital stay after surgery were longer in the LADG-ESD than in the ODG-ESD, number of LN dissections was statistically identical in these 2 groups. Operative complications in the LADG-ESD (16.0%) was higher than that in the LADG-standard (3.8% - 8.2%) but similar to that in the ODG-ESD (13.9%). Conclusion: The present study suggests that LADG contributes to the effectiveness of the treatment of choice for non-curative endoscopic resection.


Cite this paper
T. Suzuki, K. Tanabe, D. Vu, T. Misumi, N. Fujikuni, N. Tokumoto and H. Ohdan, "Safety and Efficacy of Laparoscopy-Assisted Gastrectomy after Endoscopic Submucosal Dissection for Early Gastric Cancer: A Retrospective Report," Journal of Cancer Therapy, Vol. 4 No. 1, 2013, pp. 54-60. doi: 10.4236/jct.2013.41A008.
References
[1]   Y. Sanomura, S. Oka, S. Tanaka, M. Higashiyama, S. Yoshida and K. Arihiro, “Predicting the Absence of Lymph Node Metastasis of Submucosal Invasive Gastric Cancer: Expansion of the Criteria for Curative Endoscopic Resection,” Scandinavian Journal of Gastroenterology, Vol. 45, No. 12, 2010, pp. 1480-1487. doi:10.3109/00365521.2010.505659

[2]   T. Sano and Y. Kodera, “Japanese Classification of Gastric Carcinoma: 3rd English Edition,” Gastric Cancer, Vol. 14, No. 2, 2011, pp. 101-112. doi:10.1007/s10120-011-0041-5

[3]   O. Goto, M. Fujishiro, S. Kodashima, S. Ono and M. Omata, “Outcomes of Endoscopic Submucosal Dissection for Early Gastric Cancer with Special Reference to Validation for Curability Criteria,” Endoscopy, Vol. 41, No. 2, 2009, pp. 118-122. doi:10.1055/s-0028-1119452

[4]   J. S. Jang, S. R. Choi, W. Qureshi, M. C. Kim, S. J. Kim and J. S. Jeung, “Long-Term Outcomes of Endoscopic Submucosal Dissection in Gastric Neoplastic Lesions at a Single Institution in South Korea,” Scandinavian Journal of Gastroenterology, Vol. 44, No. 11, 2009, pp. 1315-1322. doi:10.3109/00365520903254304

[5]   S. Oka, S. Tanaka, I. Kaneko, R. Mouri, M. Hirata and T. Kawamura, “Advantage of Endoscopic Submucosal Dissection Compared with EMR for Early Gastric Cancer,” Gastrointestinal Endoscopy, Vol. 64, No. 6, 2006, pp. 877-883. doi:10.1016/j.gie.2006.03.932

[6]   T. Gotoda, “Endoscopic Resection of Early Gastric Cancer,” Gastric Cancer, Vol. 10, No. 1, 2007, pp. 1-11. doi:10.1007/s10120-006-0408-1

[7]   M. Tanaka, H. Ono, N. Hasuike and K. Takizawa, “Endoscopic Submucosal Dissection of Early Gastric Cancer,” Digestion, Vol. 77, No. Suppl 1, 2008, pp. 23-28. doi:10.1159/000111484

[8]   R. Takenaka, Y. Kawahara, H. Okada, T. Tsuzuki, S. Yagi and J. Kato, “Endoscopic Submucosal Dissection for Cancers of the Remnant Stomach after Distal Gastrectomy,” Gastrointestinal Endoscopy, Vol. 67, No. 2, 2008, pp. 359-363. doi:10.1016/j.gie.2007.10.021

[9]   Y. Adachi, N. Shiraishi and S. Kitano, “Modern Treatment of Early Gastric Cancer: Review of the Japanese Experience,” Digestive Surgery, Vol. 19, No. 5, 2002, pp. 333-339. doi:10.1159/000065829

[10]   Y. Adachi, N. Shiraishi, K. Ikebe, M. Aramaki, T. Bandoh and S. Kitano, “Evaluation of the Cost for Laparoscopic-Assisted Billroth I Gastrectomy,” Surgical Endoscopy, Vol. 15, No. 9, 2001, pp. 932-936. doi:10.1007/s004640090089

[11]   Y. Adachi, N. Shiraishi, A. Shiromizu, T. Bandoh, M. Aramaki and S. Kitano, “Laparoscopy-Assisted Billroth I Gastrectomy Compared with Conventional Open Gastrectomy,” Archives of Surgery, Vol. 135, No. 7, 2000, pp. 806-810. doi:10.1001/archsurg.135.7.806

[12]   T. Asao, Y. Hosouchi, T. Nakabayashi, N. Haga, E. Mochiki and H. Kuwano, “Laparoscopically Assisted Total or Distal Gastrectomy with Lymph Node Dissection for Early Gastric Cancer,” British Journal of Surgery, Vol. 88, No. 1, 2001, pp. 128-132. doi:10.1046/j.1365-2168.2001.01618.x

[13]   Y. W. Kim, Y. H. Baik, Y. H. Yun, B. H. Nam, D. H. Kim and I. J. Choi, “Improved Quality of Life Outcomes after Laparoscopy-Assisted Distal Gastrectomy for Early Gastric Cancer: Results of a Prospective Randomized Clinical Trial,” Annals of Surgery, Vol. 248, No. 5, 2008, pp. 721-727. doi:10.1097/SLA.0b013e318185e62e

[14]   H. Hayashi, T. Ochiai, H. Shimada and Y. Gunji, “Prospective Randomized Study of Open versus Laparoscopy-Assisted Distal Gastrectomy with Extraperigastric Lymph Node Dissection for Early Gastric Cancer,” Surgical Endoscopy, Vol. 19, No. 9, 2005, pp. 1172-1176. doi:10.1007/s00464-004-8207-4

[15]   S. Kitano, N. Shiraishi, K. Kakisako, K. Yasuda, M. Inomata and Y. Adachi, “Laparoscopy-Assisted Billroth-I Gastrectomy (LADG) for Cancer: Our 10 Years’ Experience,” Surgical Laparoscopy Endoscopy & Percutaneous Techniques, Vol. 12, No. 3, 2002, pp. 204-207. doi:10.1097/00129689-200206000-00021

[16]   G. A. Jeong, G. S. Cho, H. H. Kim, H. J. Lee, S. W. Ryu and K. Y. Song, “Laparoscopy-Assisted Total Gastrectomy for Gastric Cancer: A Multicenter Retrospective Analysis,” Surgery, Vol. 146, No. 3, 2009, pp. 469-474. doi:10.1016/j.surg.2009.03.023

[17]   J. H. Lee and H. S. Han, “A Prospective Randomized Study Comparing Open vs. Laparoscopy-Assisted Distal Gastrectomy in Early Gastric Cancer: Early Results,” Surgical Endoscopy, Vol. 19, No. 2, 2005, pp. 168-173. doi:10.1007/s00464-004-8808-y

[18]   J. Song, H. J. Lee, G. S. Cho, S. U. Han, M. C. Kim and S. W. Ryu, “Recurrence Following Laparoscopy-Assisted Gastrectomy for Gastric Cancer: A Multicenter Retrospective Analysis of 1417 Patients,” Annals of Surgical Oncology, Vol. 17, No. 7, 2010, pp. 1777-1786. doi:10.1245/s10434-010-0932-4

[19]   T. Akagi, N. Shiraishi, K. Hiroishi, T. Etoh, K. Yasuda and S. Kitano, “Case Series of Intra-Abdominal Adhesions Induced by Artificial Ulceration after Endoscopic Submucosal Dissection before Additional Laparoscopic Gastrectomy,” Gastrointestinal Endoscopy, Vol. 72, No. 2, 2010, pp. 438-443. doi:10.1016/j.gie.2010.03.1066

[20]   B. Walter, A. Probst, B. Markl, T. Wagner, M. Anthuber and H. Messmann, “Fulminant Metastatic Spread in a Patient with an Early Gastric Cancer,” Endoscopy, Vol. 41, No. 10, 2009, pp. 907-909. doi:10.1055/s-0029-1215062

[21]   Japanese Gastric Cancer A, “Japanese Classification of Gastric Carcinoma—2nd English Edition,” Gastric Cancer, Vol. 1, No. 1, 1998, pp. 10-24.

[22]   J. G. C. Association, “Japanese Classification of Gastric Carcinoma. 2nd English Edition,” Gastric Cancer, Vol. 1, No. 1, 1998, pp. 10-24.

[23]   W. J. Hyung, J. H. Cheong, J. Kim, J. Chen, S. H. Choi and S. H. Noh, “Application of Minimally Invasive Treatment for Early Gastric Cancer,” Journal of Surgical Oncology, Vol. 85, No. 4, 2004, pp. 181-185. doi:10.1002/jso.20018

[24]   H. Jung, J. M. Bae, M. G. Choi, J. H. Noh, T. S. Sohn and S. Kim, “Surgical Outcome after Incomplete Endoscopic Submucosal Dissection of Gastric Cancer,” British Journal of Surgery, Vol. 98, No. 1, 2011, pp. 73-78. doi:10.1002/bjs.7274

[25]   K. W. Ryu, I. J. Choi, Y. W. Doh, M. C. Kook, C. G. Kim and H. J. Park, “Surgical Indication for Non-Curative Endoscopic Resection in Early Gastric Cancer,” Annals of Surgical Oncology, Vol. 14, No. 12, 2007, pp. 3428-3434. doi:10.1245/s10434-007-9536-z

[26]   S. Kitano, Y. Iso, M. Moriyama and K. Sugimachi, “Laparoscopy-Assisted Billroth I Gastrectomy,” Surgical Laparoscopy Endoscopy & Percutaneous Techniques, Vol. 4, No. 2, 1994, pp. 146-148.

[27]   K. Y. Song, W. J. Hyung, H. H. Kim, S. U. Han, G. S. Cho and S. W. Ryu, “Is Gastrectomy Mandatory for All Residual or Recurrent Gastric Cancer Following Endoscopic Resection? A Large-Scale Korean Multi-Center Study,” Journal of Surgical Oncology, Vol. 98, No. 1, 2008, pp. 6-10. doi:10.1002/jso.21074

[28]   E. Wilson, K. Gurusamy, C. Gluud and B. R. Davidson, “Cost-Utility and Value-of-Information Analysis of Early versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis,” British Journal of Surgery, Vol. 97, No. 2, 2010, pp. 210-219. doi:10.1002/bjs.6872

[29]   K. Gurusamy, K. Samraj, C. Gluud, E. Wilson and B. R. Davidson, “Meta-Analysis of Randomized Controlled Trials on the Safety and Effectiveness of Early versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis,” British Journal of Surgery, Vol. 97, No. 2, 2010, pp. 141-150. doi:10.1002/bjs.6870

 
 
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