Totally laparoscopic gastrectomy for gastric cancer after endoscopic submucosal dissection : a propensity score matching analysis

Ebihara Yuma; Okushiba Shunichi; Kurashima Yo; Noji Takehiro; Nakamura Toru; Murakami Soichi; Tamoto Eiji; Tsuchikawa Takahiro; Okamura Keisuke; Shichinohe Toshiaki; Hirano Satoshi

Title	en Totally laparoscopic gastrectomy for gastric cancer after endoscopic submucosal dissection : a propensity score matching analysis
Alternative	en Totally LG for gastric cancer after ESD
Creator	en Ebihara, Yuma NRID 1000050632981 en Okushiba, Shunichi en Kurashima, Yo en Noji, Takehiro NRID 1000010739296 en Nakamura, Toru NRID 1000070645796 en Murakami, Soichi en Tamoto, Eiji en Tsuchikawa, Takahiro NRID 1000050507572 en Okamura, Keisuke en Shichinohe, Toshiaki NRID 1000070374353 en Hirano, Satoshi NRID 1000050322813
Accessrights	open access
Rights	en The final publication is available at link.springer.com
Subject	Other en Totally laparoscopic gastrectomy Other en Endoscopic submucosal dissection Other en Early gastric cancer NDC 490
Description	Abstract en Purpose: A recently developed endoscopic mucosal resection (EMR) procedure, endoscopic submucosal dissection (ESD), makes en-bloc resection possible for mucosal cancer regardless of lesion size. ESD involves deeper and wider dissection of the gastric wall, and may therefore increase the difficulty of subsequent totally laparoscopic gastrectomy (TLG) and the risk of complications. However, the influence of ESD on subsequent TLG has yet to be demonstrated. The purpose of the present study was to clarify the influence of ESD on subsequent TLG. Methods: Between March 2006 and December 2013, we retrospectively collected data of 38 patients undergoing TLG with ESD (ESD Group) and propensity score matched 38 patients undergone TLG without ESD (non-ESD Group) for treatment of gastric cancer at Tonan Hospital and Hokkaido University Hospital. The covariates for propensity score matching were: age, sex, American Society of Anesthesiologists score, body mass index, and type of surgery. Clinicopathologic characteristics and surgical outcomes were compared between the two groups. Results: Operative times for TLG in ESD group and non-ESD group were 228.2 ± 53.9 and 228.1 ± 52.7 min (P=0.989), and blood loss was 45.7 ± 83.0, 71.3 ± 74.5 g, respectively (P=0.161). There were no significant differences between the groups of ESD and non-ESD in postoperative recovery and postoperative complications. In totally laparoscopic distal gastrectomy (TLDG), the patients with ESD-resected specimens of more than 50 mm in diameter had significantly longer operative times (P=0.009). Conclusions: In this study, TLG is feasible procedure treatment of gastric cancer regardless of ESD. However, TLDG is more difficult in cases where the ESD-resected specimen is more than 50 mm in diameter.
Publisher	en Springer
Date	Issued2015-12
Language	eng
Resource Type	journal article
Version Type	AM
Identifier	HDL http://hdl.handle.net/2115/63709
Relation	isVersionOf DOI https://doi.org/10.1007/s00423-015-1349-0 PMID 26476630
Journal	PISSN 1435-2443 NCID AA11211080 en Langenbeck's Archives of Surgery Volume Number400 Issue Number8 Page Start967 Page End972
File	fulltext LangenbecksArchSurg400_967.pdf 221.82 KB (application/pdf) Issued2015-12
Oaidate	2023-07-26