Yoontaek Lee, MD, Sa-Hong Min, MD, Young Suk Park, MD, Sang-Hoon Ahn, MD, Do Joong Park, MD, PhD. Seoul National University Bundang Hospital
Purpose: Laparoscopic transhiatal approach(LA) for esophagogastric junction cancer has advantage in point of providing better view comparing with open approach(OA). In the present study, we focus on the surgical outcomes comparing LA with OA.
Methods: A total of 108 patients with Esophagogastric junction cancer who underwent gastrectomy with curative intent at Seoul National University Bundang Hospital between 2003 and 2017 were analyzed. Surgical outcomes were reviewed using electronic medical records.
Results: Thirty-seven patients underwent LA, and 71 underwent OA. Compared with OA, LA was associated with significantly less postoperative hospitalization duration (10.1 vs. 14.9 days, p=0.019) and extended operation time (251.5 vs. 213.8 min, p = 0.032). There was no significant difference between LA and OA in intraoperative blood loss (150 vs. 170 ml, p = 0.631), proximal resection margin(0.8 vs. 0.9 cm, p=0.555), or rate of surgical morbidity(≥grade 2) for complications (8.1 vs 23.9 %, p=0.080). There were 2 cases of anastomotic leakage in OA group and no anastomotic leakage in LA group. There was no difference between groups in total number of harvested lymph nodes (58.5 vs. 57.7, p=0.889). The 5-year overall survival rate and 3-year disease free survival rate were 81.8% and 79.7% for LA, and 50.7% and 56.1% for OA(p=0.024 & 0.046). In multivariate analysis, TNM stage was the only independent factor associate with survival.
Conclusion: LA for esophagogastric junction cancer appears feasible and safe in short-term or long-term oncologic outcomes.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86924
Program Number: P439
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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