| Title: | Totally laparoscopic gastrectomy for gastric cancer after endoscopic submucosal dissection : a propensity score matching analysis |
| Other Titles: | Totally LG for gastric cancer after ESD |
| Authors: | Ebihara, Yuma Browse this author →KAKEN DB |
| Okushiba, Shunichi Browse this author |
| Kurashima, Yo Browse this author |
| Noji, Takehiro Browse this author →KAKEN DB |
| Nakamura, Toru Browse this author →KAKEN DB |
| Murakami, Soichi Browse this author |
| Tamoto, Eiji Browse this author |
| Tsuchikawa, Takahiro Browse this author →KAKEN DB |
| Okamura, Keisuke Browse this author |
| Shichinohe, Toshiaki Browse this author →KAKEN DB |
| Hirano, Satoshi Browse this author →KAKEN DB |
| Keywords: | Totally laparoscopic gastrectomy |
| Endoscopic submucosal dissection |
| Early gastric cancer |
| Issue Date: | Dec-2015 |
| Publisher: | Springer |
| Journal Title: | Langenbeck's Archives of Surgery |
| Volume: | 400 |
| Issue: | 8 |
| Start Page: | 967 |
| End Page: | 972 |
| Publisher DOI: | 10.1007/s00423-015-1349-0 |
| PMID: | 26476630 |
| Abstract: | 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. |
| Rights: | The final publication is available at link.springer.com |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/63709 |
| Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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