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Laparoscopic versus open distal gastrectomy for locally advanced gastric cancer after neoadjuvant chemotherapy: safety and short-term oncologic results

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Abstract

Background

To compare the safety and efficacy of laparoscopic distal gastrectomy (LDG) versus open distal gastrectomy (ODG) in treating locally advanced distal gastric cancer after neoadjuvant chemotherapy (NACT).

Methods

Forty-four patients with locally advanced distal gastric cancer were enrolled. The patients received neoadjuvant chemotherapy before undergoing surgery. Twenty patients were allocated into LDG after NACT group and 24 patients into ODG after NACT group. Radicalness of oncological resection, surgical safety and recovery were measured and compared.

Results

All operations were successfully performed without severe postoperative complications. There were no significant differences in blood loss, mean operation time, complications, distal and proximal resection margin, and number of retrieved lymph nodes between LDG and ODG groups, but LDG group had shorter length of incision and the first aerofluxus time.

Conclusion

Laparoscopic distal gastrectomy after NACT has comparable results with open distal gastrectomy in safety and efficacy in the short term.

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References

  1. Kitano S, Iso Y, Moriyama M, Sugimachi K (1994) Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 4(2):146–148

    CAS  PubMed  Google Scholar 

  2. Bo T, Peiwu Y, Feng Q, Yongliang Z, Yan S, Yingxue H, Huaxing L (2013) Laparoscopy-assisted vs. open total gastrectomy for advanced gastric cancer: long-term outcomes and technical aspects of a case-control study. J Gastrointest Surg 17(7):1202–1208. doi:10.1007/s11605-013-2218-1

    Article  CAS  PubMed  Google Scholar 

  3. Wu LM, Jiang XJ, Lin QF, Jian CX (2015) Comparative study of clinical efficacy of laparoscopy-assisted radical gastrectomy versus open radical gastrectomy for advanced gastric cancer. Genet Mol Res GMR 14(2):3459–3465. doi:10.4238/2015.April.15.9

    Article  CAS  PubMed  Google Scholar 

  4. Hu Y, Ying M, Huang C, Wei H, Jiang Z, Peng X, Hu J, Du X, Wang B, Lin F, Xu J, Dong G, Mou T, Li G, Chinese Laparoscopic Gastrointestinal Surgery Study Group (2014) Oncologic outcomes of laparoscopy-assisted gastrectomy for advanced gastric cancer: a large-scale multicenter retrospective cohort study from China. Surg Endosc 28(7):2048–2056. doi:10.1007/s00464-014-3426-9

    Article  PubMed  Google Scholar 

  5. Topal B, Leys E, Ectors N, Aerts R, Penninckx F (2008) Determinants of complications and adequacy of surgical resection in laparoscopic versus open total gastrectomy for adenocarcinoma. Surg Endosc 22(4):980–984. doi:10.1007/s00464-007-9549-5

    Article  CAS  PubMed  Google Scholar 

  6. Nakajima T (2002) Gastric cancer treatment guidelines in Japan. Gastric Cancer 5(1):1–5. doi:10.1007/s101200200000

    Article  PubMed  Google Scholar 

  7. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45(2):228–247. doi:10.1016/j.ejca.2008.10.026

    Article  CAS  PubMed  Google Scholar 

  8. Japanese Gastric Cancer Association (2011) Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 14(2):113–123. doi:10.1007/s10120-011-0042-4

    Article  Google Scholar 

  9. Japanese Gastric Cancer Association (2011) Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 14(2):101–112. doi:10.1007/s10120-011-0041-5

    Article  Google Scholar 

  10. Sobin LH, Gospodarowicz MK, Wittekind C, International Union against Cancer (2010) TNM classification of malignant tumours, 7th edn. Wiley, Chichester

    Google Scholar 

  11. National Comprehensive Cancer Network (2015) Gastric cancer (version 3.2015). https://www.nccn.org/professionals/physician_gls/pdf/gastric.pdf. Accessed 21 June 2015

  12. Downie WW, Leatham PA, Rhind VM, Wright V, Branco JA, Anderson JA (1978) Studies with pain rating scales. Ann Rheum Dis 37(4):378–381

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, Fainsinger R, Aass N, Kaasa S, European Palliative Care Research Collaborative (2011) Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manag 41(6):1073–1093. doi:10.1016/j.jpainsymman.2010.08.016

    Article  Google Scholar 

  14. Clavien PA, Sanabria JR, Strasberg SM (1992) Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery 111(5):518–526

    CAS  PubMed  Google Scholar 

  15. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sakuramoto S, Sasako M, Yamaguchi T, Kinoshita T, Fujii M, Nashimoto A, Furukawa H, Nakajima T, Ohashi Y, Imamura H, Higashino M, Yamamura Y, Kurita A, Arai K, ACTS-GC Group (2007) Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med 357(18):1810–1820. doi:10.1056/NEJMoa072252

    Article  CAS  PubMed  Google Scholar 

  17. Schuhmacher C, Gretschel S, Lordick F, Reichardt P, Hohenberger W, Eisenberger CF, Haag C, Mauer ME, Hasan B, Welch J, Ott K, Hoelscher A, Schneider PM, Bechstein W, Wilke H, Lutz MP, Nordlinger B, Van Cutsem E, Siewert JR, Schlag PM (2010) Neoadjuvant chemotherapy compared with surgery alone for locally advanced cancer of the stomach and cardia: European Organisation for Research and Treatment of Cancer randomized trial 40954. J Clin Oncol 28(35):5210–5218. doi:10.1200/JCO.2009.26.6114

    Article  PubMed  PubMed Central  Google Scholar 

  18. Li ZY, Shan F, Zhang LH, Bu ZD, Wu AW, Wu XJ, Zong XL, Wu Q, Ren H, Ji JF (2011) Complications after radical gastrectomy following FOLFOX7 neoadjuvant chemotherapy for gastric cancer. World J Surg Oncol 9:110. doi:10.1186/1477-7819-9-110

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This work was funded by Beijing Municipal Science and Technology Commission (Z151100004015070).

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Correspondence to Jiafu Ji.

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Disclosures

Drs. Ziyu Li, Fei Shan, Yinkui Wang, Lianhai Zhang, Shuangxi Li, Yongning Jia, Daoxin Yin, Jiafu Ji have no conflicts of interest or financial ties to disclose.

Additional information

Ziyu Li, Fei Shan and Yinkui Wang have contributed equally to this work.

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Li, Z., Shan, F., Wang, Y. et al. Laparoscopic versus open distal gastrectomy for locally advanced gastric cancer after neoadjuvant chemotherapy: safety and short-term oncologic results. Surg Endosc 30, 4265–4271 (2016). https://doi.org/10.1007/s00464-015-4739-z

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