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Gastric Cancer And Laparoscopic Surgery

Matthias Paireder, Reza Asari, Ivan Kristo, Erwin Rieder, Johannes Zacherl, Barbara Kabon, Edith Fleischmann, Sebastian F Schoppmann
Background: The minimally invasive esophagectomy (MIE) for esophageal cancer was introduced assuming a reduction of morbidity and operation time. After implementation of MIE at our institution, a randomized controlled trial was designed. Methods: This is a prospective randomized controlled study comparing open (OE) and laparoscopic gastric tube (MIE) formation in Ivor Lewis esophagectomy. Primary endpoints were morbidity and 30-day mortality. Secondary endpoints included the duration of intensive care unit stay, length of hospital stay, operative time as well as relapse-free and overall survival...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
Yoontaek Lee, Donghwan Ha, Liang An, You-Jin Jang, Hyub Huh, Chang Min Lee, Yeon-Hee Kim, Jong-Han Kim, Seong-Heum Park, Young-Jae Mok, Il Ok Lee, Oh Kyoung Kwon, Kyung Hwa Kwak, Jae Seok Min, Eun Jin Kim, Sung Il Choi, Jae Woo Yi, Oh Jeong, Mi Ran Jung, Hong Bum Bae, Joong-Min Park, Yong Hoon Jung, Jin-Jo Kim, Dal Ah Kim, Sungsoo Park
PURPOSE: Many studies have demonstrated the advantage of maintaining intraoperative deep neuromuscular block (NMB) with sugammadex. This trial is designed to evaluate the impact of muscle relaxation during laparoscopic subtotal gastrectomy on the oncological benefits, particularly in obese patients with gastric cancer. MATERIALS AND METHODS: This is a double-blind, randomized controlled multicenter prospective trial. Patients with clinical stage I-II gastric cancer with a body mass index of 25 and over, who undergo laparoscopic subtotal gastrectomy will be eligible for trial inclusion...
December 2018: Medicine (Baltimore)
Michitaka Honda, Hiraku Kumamaru, Tsuyoshi Etoh, Hiroaki Miyata, Yuichi Yamashita, Kazuhiro Yoshida, Yasuhiro Kodera, Yoshihiro Kakeji, Masafumi Inomata, Hiroyuki Konno, Yasuyuki Seto, Seigo Kitano, Masahiko Watanabe, Naoki Hiki
BACKGROUND: Laparoscopic gastrectomy (LG) might have greater clinical benefits for elderly patients as less invasive surgery; however, there is still little evidence to support its benefit. We evaluated the surgical outcomes of elderly patients in a nationwide prospective cohort study. METHODS: One hundred and sixty-nine participating institutions were identified by stratified random sampling, and were adjusted for hospital volume, type and location. During 1 year from 2014 to 2015, consecutive patients who underwent gastrectomy for gastric cancer were prospectively enrolled...
December 11, 2018: Gastric Cancer
Satoru Kikuchi, Shinji Kuroda, Masahiko Nishizaki, Takashi Matsusaki, Kazuya Kuwada, Yoshikazu Kimura, Shunsuke Kagawa, Hiroshi Morimatsu, Toshiyoshi Fujiwara
PURPOSE: Epidural analgesia (EDA) is an imperative modality for postoperative pain relief after major open abdominal surgery. However, whether EDA has benefits in laparoscopic surgery has not been clear. In this study, the effects of EDA and patient-controlled intravenous analgesia (PCIA) after laparoscopic distal gastrectomy (LDG) were compared. METHODS: This was a retrospective study that included 82 patients undergoing LDG for gastric cancer. Patients received either EDA (n=67) or PCIA (n=15) for postoperative pain relief...
December 3, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Won Ho Han, Amir Ben Yehuda, Deok-Hee Kim, Seung Geun Yang, Bang Wool Eom, Hong Man Yoon, Young-Woo Kim, Keun Won Ryu
Objective: Laparoscopic gastrectomy has been established as a standard treatment for early gastric cancer, and its use is increasing recently. Compared with the conventional laparoscopy-assisted distal gastrectomy (LADG), totally laparoscopic distal gastrectomy (TLDG) involves intracorporeal reconstruction, which can avoid the additional incision, resulting in pain reduction and early recovery. This study aimed to compare the short-term postoperative outcomes of TLDG vs. LADG in gastric cancer in a high-volume center...
October 2018: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Rulin Miao, Jianjun Qu, Zhengrong Li, Daguang Wang, Jiang Yu, Weidong Zang, Yong Li, Fenglin Liu, Jian Zhang, Wu Song, Kai Ye, Su Yan, Wei Wang, Shuangyi Ren, Lu Zang, Changqing Jing, Li Zhang, Kuan Wang, Weihua Fu, Lin Fan, Bin Liang, Gang Zhao, Jun Cai, Li Yang, Jiaming Zhu, Jun You, Kun Yang, Qingxing Huang, Zhaojian Niu, Ning Ning, Xingfeng Qiu, Gang Ji, Feng Liang, Hua Huang, Chao Gao, Fei Shan, Shuangxi Li, Yongning Jia, Lianhai Zhang, Xiangji Ying, Yan Zhang, Zhaode Bu, Xiangqian Su, Gang Zhao, Ziyu Li, Jiafu Ji
Objective: Infra-pyloric artery (IPA) is an important anatomical landmark in treatment of gastric cancer and is the key vessel for pylorus-preserving gastrectomy and subgroup of infra-pyloric lymph nodes. However, its anatomical variation is not thoroughly understood. Our study aimed to clarify the origination of the IPA. Methods: We did this prospective, multicenter, open-label, observational study at gastric surgery departments of 34 hospitals in China. Gastric cancer patients aged 18 years or older and scheduled to undergo elective total or distal gastrectomy were assigned...
October 2018: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Aolin Shen, Shengyun Wan, Bo Qian, Long Ma, Shuhan Yang, Biao Liu, Lei Zhang, Guodong Shen
OBJECTIVE: To explore the application value of intraoperative ultrasound (IU) in laparoscopic lymphadenectomy of gastric cancer. METHODS: Patients with gastric cancer undergoing laparoscopic radical D2 gastrectomy at General Surgery of the Second Affiliated Hospital of Anhui Medical University between August 2016 and May 2018 were prospectively enrolled and were randomly divided into IU group (n=78) and conventional group (n=91). The conventional group underwent laparoscopy only...
November 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Wenjun Xiong, Wei Wang, Jin Wan
Acute perforated gastric cancer (GC) is defined as an acute perforation of primary GC. It is a rare surgical acute abdominal disease that is mainly caused by advanced GC. The onset of acute perforation of GC is related to the depth of invasion. Preoperative diagnosis is very difficult for GC with acute perforation. The main method to confirm malignant perforation is intraoperative frozen section, which also is the primary clinical standard at present. The primary treatment for GC with acute perforation is surgical intervention, which is associated with high morbidity and mortality...
November 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Yuki Aisu, Daiki Yasukawa, Yusuke Kimura, Tomohide Hori
Laparoscopic and endoscopic cooperative surgery (LECS) is a surgical technique that combines laparoscopic partial gastrectomy and endoscopic submucosal dissection. LECS requires close collaboration between skilled laparoscopic surgeons and experienced endoscopists. For successful LECS, experience alone is not sufficient. Instead, familiarity with the characteristics of both laparoscopic surgery and endoscopic intervention is necessary to overcome various technical problems. LECS was developed mainly as a treatment for gastric submucosal tumors without epithelial lesions, including gastrointestinal stromal tumors (GISTs)...
November 15, 2018: World Journal of Gastrointestinal Oncology
Kai Liu, Xin-Zu Chen, Wei-Han Zhang, Dong-Yang Zhang, Yi Luo, Yue Yu, Kun Yang, Shi-Jie Yang, Xiao-Long Chen, Li-Fei Sun, Lin-Yong Zhao, Zong-Guang Zhou, Jian-Kun Hu
BACKGROUND: The preoperative work-up has limitations on finding peritoneal dissemination (PD) in gastric cancer patients. Laparoscopic exploration (LE) can discover radiographically occult PD, obtain accurate stage and avert futile laparotomy. The aim of our study was to introduce "Four-Step Procedure" LE in West China Hospital and further evaluate its safety and feasibility. METHODS: We conducted a retrospective analysis on 165 patients from July 2016 to December 2017 who underwent "Four-Step Procedure" LE in gastrointestinal surgery department of West China Hospital...
November 26, 2018: Surgical Endoscopy
Ziyu Li, Fei Shan, Xiangji Ying, Kan Xue, Jiafu Ji
BACKGROUND: Gastric cancer is one of the most common malignant tumors worldwide. With the rapid aging of global population, the number of elderly patients with local advanced gastric cancer is increasing. Surgery is the essential treatment for local advanced gastric cancer. However, elderly patients are at high risk of postoperative complications due to reduced functional reserve and increased comorbidities. Laparoscopic gastrectomy may be a promising surgery approach for elderly patients but its benefits remain controversial...
November 16, 2018: BMC Cancer
Masayuki Shinkai, Motohiro Imano, Yasutaka Chiba, Mitsuru Iwama, Osamu Shiraisi, Atsushi Yasuda, Masanobu Tsubaki, Shozo Nishida, Yutaka Kimura, Takushi Yasuda
BACKGROUND: We carried out a phase II trial to evaluate the feasibility and efficacy of neoadjuvant chemotherapy comprising a single intraperitoneal administration of paclitaxel, followed by intravenous administrations of paclitaxel and cisplatin with S-1 for clinical stage III gastric cancer. METHODS: Patients with potentially resectable gastric cancer were eligible. A laparoscopic survey was performed to confirm CY0 and P0. Intraperitoneal paclitaxel (60 mg/m 2 ) was administered, followed by systemic chemotherapy...
November 15, 2018: Journal of Surgical Oncology
J Min, K Qian, X X Wu, Z W Wang, W Zhang
Objective: To explore the safety and efficacy of mesogastrium excision above the pancreas by the right approach in radical distal gastrectomy for cancer. Methods: A total of 154 distal gastric cancer patients in the Department of Gastrointestinal Surgery of the first affiliated Hospital of Chongqing Medical University, from October 2013 to October 2014, were included in this random controlled study. These patients were divided into the study group ( n =78), who received mesogastrium excision above the pancreas by the right approach, and the control group ( n =76), who received mesogastrium excision above the pancreas when by the left approach...
November 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Jun Luo, Yu Zhu, Hao Liu, Yan-Feng Hu, Tuan-Jie Li, Tian Lin, Tao Chen, Hao Chen, Xin-Hua Chen, Jiang Yu, Guo-Xin Li
Laparoscopy-assisted distal gastrectomy (LDG) combined with D2 lymphadenectomy may be safely performed in patients with advanced gastric cancer (AGC) by experienced surgeons at specialized high-volume institutions as shown in the Chinese Laparoscopic Gastrointestinal Surgery Study (CLASS)-01. However, studies focusing on the use of LDG in patients with gastric cancer older than 65 years are rare. This study was designed to investigate the morbidity and mortality of elderly patients with gastric cancer who underwent laparoscopic-assisted or open distal gastrectomy (ODG)...
November 2018: Gastroenterology Report
Mingjie Xia, Xinyuan Guo, Quan Wang
Objective: Totally laparoscopic distal gastrectomy (TLDG) with intracorporeal anastomosis is feasible because of improved approaches to laparoscopic surgery and the availability of a variety of surgical instruments. This study was designed to evaluate the practicality, safety and short-term operative outcomes of intracorporeal gastroduodenostomy in TLDG for gastric cancer. Materials and Methods: Medical records of patients with primary distal gastric cancer undergoing Billroth I (B-I) (n = 37) or B-II anastomosis (n = 41) in TLDG from February 2010 to November 2015 were retrospectively analysed...
November 9, 2018: Journal of Minimal Access Surgery
Takatsugu Fujii, Shusuke Haruta, Yu Ohkura, Aya Honda, Nao Kobayashi, Tsuyoshi Tanaka, Masaki Ueno, Harushi Udagawa
Diaphragmatic eventration refers to an abnormal elevation of the diaphragm. Here, we report the case of a patient with gastric cancer who underwent successful laparoscopic distal gastrectomy despite the presence of diaphragmatic eventration. The patient was a 72-year-old man diagnosed with early gastric cancer in the antrum, as detected by upper gastrointestinal endoscopy. Preoperative imaging revealed an elevation of the left side of the diaphragm, which was diagnosed as diaphragmatic eventration. Laparoscopic surgery is beneficial for obtaining an optimal field of view...
November 8, 2018: Asian Journal of Endoscopic Surgery
Tomoyuki Okumura, Yasuyuki Seto, Susumu Aikou, Makoto Moriyama, Shinich Sekine, Isaya Hashimoto, Kazuto Shibuya, Shozo Hojo, Isaku Yoshioka, Takuya Nagata, Tsutomu Fujii
We herein report a case of mediastinoscopic salvage esophagectomy for recurrent esophageal squamous cell carcinoma after definitive chemoradiotherapy in a previously pneumonectomized patient. A 66-year-old man with a medical history of left-sided pneumonectomy for lung cancer was diagnosed with local recurrence of lower esophageal squamous cell carcinoma (cT3N0M0 cStage II) 9 years after definitive chemoradiotherapy. The mediastinoscopic cervical approach and laparoscopic transhiatal approach were combined, and the thoracic esophagus was safely mobilized to separate the esophagus from the stump of the left bronchus and to divide dense adhesions between the esophagus and fibrotic tissue at the site of the previous left mediastinal pleural resection...
November 8, 2018: Asian Journal of Endoscopic Surgery
Dae Hwa Park, Hee Seok Moon, Ji Young Sul, In Sun Kwon, Gee Young Yun, Seo Hee Lee, Jae Ho Park, Ju Seok Kim, Sun Hyung Kang, Eaum Seok Lee, Seok Hyun Kim, Jae Kyu Sung, Byung Seok Lee, Hyun Yong Jeong
In this study, we evaluate the usefulness of preoperative endoscopic clipping for early gastric cancer (EGC) localization in laparoscopic distal gastrectomy.We retrospectively screened all consecutive patients who underwent laparoscopic distal gastrectomy for EGC by 1 surgeon at Chungnam National University Hospital between January 2014 and December 2016. Patients who underwent combined surgery and patients who had tumors at the lower third of the stomach were excluded. Endoscopic clipping was performed prior to surgery by specialized endoscopists...
November 2018: Medicine (Baltimore)
Zaozao Wang, Jiadi Xing, Jun Cai, Zhongtao Zhang, Fei Li, Nengwei Zhang, Jixiang Wu, Ming Cui, Ying Liu, Lei Chen, Hong Yang, Zhi Zheng, Xiaohui Wang, Chongchong Gao, Zhe Wang, Qing Fan, Yanlei Zhu, Shulin Ren, Chenghai Zhang, Maoxing Liu, Jiafu Ji, Xiangqian Su
BACKGROUND: Although laparoscopic surgery has been recommended as an optional therapy for patients with early gastric cancer, whether patients with locally advanced gastric cancer (AGC) could benefit from laparoscopy-assisted distal gastrectomy (LADG) with D2 lymphadenectomy remains elusive due to a lack of comprehensive clinical data. To evaluate the efficacy of LADG, we conducted a multi-institutional randomized controlled trial to compare laparoscopy-assisted versus open distal gastrectomy (ODG) for AGC in North China...
November 1, 2018: Surgical Endoscopy
Takaki Yoshikawa, Hitoshi Katai
So far, JCOG Stomach Cancer Study Group had conducted phase III study to confirm efficacy of para-aortic nodaldissection( PAND), left thoraco-abdominalapproach for gastric cancer invading esophagus, spleen-preserving surgery, bursectomy, and laparoscopic surgery. JCOG9501 demonstrated that efficacy of PAND was denied but D2 was highly safe surgery. JCOG9502 showed that efficacy of thoraco-abdominalapproach was denied and transhiatalapproach was a standard procedure. JCOG0110 clearly confirmed non-inferiority of spleen-preserving surgery against splenectomy...
October 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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