Minimally invasive surgery for remnant gastric cancer: A comparison with open surgery

In Gyu Kwon, In Cho, Ali Guner, Yoon Young Choi, Hyun Beak Shin, Hyoung Il Kim, Ji Yeong An, Jae Ho Cheong, Sung Hoon Noh, Woo Jin Hyung

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Completion total gastrectomy for remnant gastric cancer (RGC) is technically challenging, especially using the minimally invasive approach. Only a few small case series have reported the technical feasibility of completion total gastrectomy by minimally invasive surgery (MIS). The aim of this study was to compare the efficacy and safety of MIS and open surgery for RGC. Methods: We retrospectively analyzed 76 completion total gastrectomies for RGC between 2005 and 2012. Indications for MIS were limited to no evidence of serosa invasion or lymph node metastasis to extraperigastric areas on preoperative evaluation. We compared patient characteristics, intraoperative factors, post-operative outcomes, and survival for the MIS and open surgery groups. Results: Eighteen patients underwent completion total gastrectomy with MIS (10 laparoscopic, 8 robotic) and 58 patients underwent open surgery. Operation time was longer in the MIS than the open group (266 vs. 203 min, P = 0.004), but the groups had similar estimated blood loss, frequency of unplanned other organ resection, and number of retrieved lymph nodes. The MIS group had a significantly earlier initiation of soft diet, shorter hospital stay, and fewer pain medication injections. Complication rates, recurrence, and overall 5-year survival were similar for the two groups. When we compared laparoscopy with robotic, similar result was shown in all parameters except operation time. Conclusions: Compared to open surgery, MIS for RGC demonstrated better short-term outcome and comparable oncologic results. MIS for RGC is feasible and safe and maintains advantages of minimal invasiveness. Both laparoscopic and robotic approaches are reasonable to the management of RGC.

Original languageEnglish
Pages (from-to)2452-2458
Number of pages7
JournalSurgical endoscopy
Volume28
Issue number8
DOIs
Publication statusPublished - 2014 Aug

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Gastric Stump
Minimally Invasive Surgical Procedures
Stomach Neoplasms
Gastrectomy
Robotics
Lymph Nodes
Serous Membrane
Survival
Laparoscopy
Length of Stay
Neoplasm Metastasis
Diet
Safety
Recurrence
Pain

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Kwon, In Gyu ; Cho, In ; Guner, Ali ; Choi, Yoon Young ; Shin, Hyun Beak ; Kim, Hyoung Il ; An, Ji Yeong ; Cheong, Jae Ho ; Noh, Sung Hoon ; Hyung, Woo Jin. / Minimally invasive surgery for remnant gastric cancer : A comparison with open surgery. In: Surgical endoscopy. 2014 ; Vol. 28, No. 8. pp. 2452-2458.
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abstract = "Background: Completion total gastrectomy for remnant gastric cancer (RGC) is technically challenging, especially using the minimally invasive approach. Only a few small case series have reported the technical feasibility of completion total gastrectomy by minimally invasive surgery (MIS). The aim of this study was to compare the efficacy and safety of MIS and open surgery for RGC. Methods: We retrospectively analyzed 76 completion total gastrectomies for RGC between 2005 and 2012. Indications for MIS were limited to no evidence of serosa invasion or lymph node metastasis to extraperigastric areas on preoperative evaluation. We compared patient characteristics, intraoperative factors, post-operative outcomes, and survival for the MIS and open surgery groups. Results: Eighteen patients underwent completion total gastrectomy with MIS (10 laparoscopic, 8 robotic) and 58 patients underwent open surgery. Operation time was longer in the MIS than the open group (266 vs. 203 min, P = 0.004), but the groups had similar estimated blood loss, frequency of unplanned other organ resection, and number of retrieved lymph nodes. The MIS group had a significantly earlier initiation of soft diet, shorter hospital stay, and fewer pain medication injections. Complication rates, recurrence, and overall 5-year survival were similar for the two groups. When we compared laparoscopy with robotic, similar result was shown in all parameters except operation time. Conclusions: Compared to open surgery, MIS for RGC demonstrated better short-term outcome and comparable oncologic results. MIS for RGC is feasible and safe and maintains advantages of minimal invasiveness. Both laparoscopic and robotic approaches are reasonable to the management of RGC.",
author = "Kwon, {In Gyu} and In Cho and Ali Guner and Choi, {Yoon Young} and Shin, {Hyun Beak} and Kim, {Hyoung Il} and An, {Ji Yeong} and Cheong, {Jae Ho} and Noh, {Sung Hoon} and Hyung, {Woo Jin}",
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Kwon, IG, Cho, I, Guner, A, Choi, YY, Shin, HB, Kim, HI, An, JY, Cheong, JH, Noh, SH & Hyung, WJ 2014, 'Minimally invasive surgery for remnant gastric cancer: A comparison with open surgery', Surgical endoscopy, vol. 28, no. 8, pp. 2452-2458. https://doi.org/10.1007/s00464-014-3496-8

Minimally invasive surgery for remnant gastric cancer : A comparison with open surgery. / Kwon, In Gyu; Cho, In; Guner, Ali; Choi, Yoon Young; Shin, Hyun Beak; Kim, Hyoung Il; An, Ji Yeong; Cheong, Jae Ho; Noh, Sung Hoon; Hyung, Woo Jin.

In: Surgical endoscopy, Vol. 28, No. 8, 08.2014, p. 2452-2458.

Research output: Contribution to journalArticle

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T1 - Minimally invasive surgery for remnant gastric cancer

T2 - A comparison with open surgery

AU - Kwon, In Gyu

AU - Cho, In

AU - Guner, Ali

AU - Choi, Yoon Young

AU - Shin, Hyun Beak

AU - Kim, Hyoung Il

AU - An, Ji Yeong

AU - Cheong, Jae Ho

AU - Noh, Sung Hoon

AU - Hyung, Woo Jin

PY - 2014/8

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N2 - Background: Completion total gastrectomy for remnant gastric cancer (RGC) is technically challenging, especially using the minimally invasive approach. Only a few small case series have reported the technical feasibility of completion total gastrectomy by minimally invasive surgery (MIS). The aim of this study was to compare the efficacy and safety of MIS and open surgery for RGC. Methods: We retrospectively analyzed 76 completion total gastrectomies for RGC between 2005 and 2012. Indications for MIS were limited to no evidence of serosa invasion or lymph node metastasis to extraperigastric areas on preoperative evaluation. We compared patient characteristics, intraoperative factors, post-operative outcomes, and survival for the MIS and open surgery groups. Results: Eighteen patients underwent completion total gastrectomy with MIS (10 laparoscopic, 8 robotic) and 58 patients underwent open surgery. Operation time was longer in the MIS than the open group (266 vs. 203 min, P = 0.004), but the groups had similar estimated blood loss, frequency of unplanned other organ resection, and number of retrieved lymph nodes. The MIS group had a significantly earlier initiation of soft diet, shorter hospital stay, and fewer pain medication injections. Complication rates, recurrence, and overall 5-year survival were similar for the two groups. When we compared laparoscopy with robotic, similar result was shown in all parameters except operation time. Conclusions: Compared to open surgery, MIS for RGC demonstrated better short-term outcome and comparable oncologic results. MIS for RGC is feasible and safe and maintains advantages of minimal invasiveness. Both laparoscopic and robotic approaches are reasonable to the management of RGC.

AB - Background: Completion total gastrectomy for remnant gastric cancer (RGC) is technically challenging, especially using the minimally invasive approach. Only a few small case series have reported the technical feasibility of completion total gastrectomy by minimally invasive surgery (MIS). The aim of this study was to compare the efficacy and safety of MIS and open surgery for RGC. Methods: We retrospectively analyzed 76 completion total gastrectomies for RGC between 2005 and 2012. Indications for MIS were limited to no evidence of serosa invasion or lymph node metastasis to extraperigastric areas on preoperative evaluation. We compared patient characteristics, intraoperative factors, post-operative outcomes, and survival for the MIS and open surgery groups. Results: Eighteen patients underwent completion total gastrectomy with MIS (10 laparoscopic, 8 robotic) and 58 patients underwent open surgery. Operation time was longer in the MIS than the open group (266 vs. 203 min, P = 0.004), but the groups had similar estimated blood loss, frequency of unplanned other organ resection, and number of retrieved lymph nodes. The MIS group had a significantly earlier initiation of soft diet, shorter hospital stay, and fewer pain medication injections. Complication rates, recurrence, and overall 5-year survival were similar for the two groups. When we compared laparoscopy with robotic, similar result was shown in all parameters except operation time. Conclusions: Compared to open surgery, MIS for RGC demonstrated better short-term outcome and comparable oncologic results. MIS for RGC is feasible and safe and maintains advantages of minimal invasiveness. Both laparoscopic and robotic approaches are reasonable to the management of RGC.

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