Y Kawakami, PhD, H Fujii, PhD, R Ohnishi, MD, M Hirasaki, PhD, S Kato, PhD, H Yoshiba, PhD, K Doi, PhD, T Aotake, PhD, Y Hirose, PhD. Japanese Red Cross Fukui Hospital
Aims: Laparoscopic proximal gastrectomy has been applied for early gastric cancer in upper third. We previously reported outcomes of laparoscopic total gastrectomy in managing this condition. In this study, we applied this modified technique for upper third early gastric cancer with double tract reconstruction. It is expected that our technique could be useful for treating these cases.
Methods: From April of 2004 to June of 2017, 69 consecutive patients with upper third early gastric cancer were assigned to undergo surgical treatment with proximal gastrectory at our hospital. We had 195 cases of total gastrectory for upper third early gastric cancer in the same study period.
Results: Clinical records of 809 cases of upper third early gastric cancer (From April of 2004 to June of 2017) were analyzed retrospectively in background factors, operative time and length of hospital stay. Of them, 28 cases were treated by laparoscopic proximal gastrectomy and 41 cases were treated by open surgery (male 17, female 11, average age of m 64.2, f 68.1, range 37-82 in laparoscopic cases, m 29, f 12, m 63.7, f 76.1, 33-88 in open cases). We had 54 laparoscopic total gastrectomy and 141 open surgery (m 35, f 19, m 68.2, f 71.0, 48-83 in laparoscopic cases, m 94, f 47, m 70.5, f 72.9 in open cases). The average operative time in the laparoscopic proximal gastrectomy group was 326 min (221-682), as was 245 (90-355) in the laparoscopic surgery group, with 344 (292-522) in the open total gastrectomy and 221(143-350) in the open surgery. The median hospital stay in the laparoscopic proximal gastrectomy group was 22.7 (13-72) days, as was 25.2 (15-44) in the open proximal group and 34.7 (16-127) in the laparoscopic total group and 29.0 (13-45) in the open total group. Postoperative body weight loss was -4.0 Kg in the laparoscopic proximal gastrectomy group and was -4.0Kg in the open group as was -3.9 in the open total group and -5.9 in the open total group.
Conclusions: We conclude that laparoscopic proximal gastrectomy for upper third early gastric cancer could be useful for reducing invasiveness while keeping a postoperative body weight loss as same as in open surgery with an attractive advantage in managing this condition.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88349
Program Number: P422
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster