Laparoscopic gastrectomy after incomplete endoscopic resection for early gastric cancer

Tsujimoto,Hironori; Yaguchi,Yoshihisa; Kumano,Isao; Takahata,Risa; Matsumoto,Yusuke; Yoshida,Kazumichi; Horiguchi,Hiroyuki; Aosasa,Suefumi; Ono,Satoshi; Yamamoto,Junji; Hase,Kazuo

doi:10.3892/or.2012.2046

Laparoscopic gastrectomy after incomplete endoscopic resection for early gastric cancer

Authors:
- Hironori Tsujimoto
- Yoshihisa Yaguchi
- Isao Kumano
- Risa Takahata
- Yusuke Matsumoto
- Kazumichi Yoshida
- Hiroyuki Horiguchi
- Suefumi Aosasa
- Satoshi Ono
- Junji Yamamoto
- Kazuo Hase
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Affiliations: Department of Surgery, National Defense Medical College, Tokorozawa 359-8513, Japan, Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Japan
Published online on: September 19, 2012 https://doi.org/10.3892/or.2012.2046
Pages: 2205-2210

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Abstract

Endoscopic submucosal dissection (ESD) utilizes electrical coagulation, which can cause burns, fibrosis and adhesion of the stomach and surrounding tissue; these complications might increase the surgical difficulties for subsequent laparoscopy-assisted gastrectomy (LAG) and the risk of complications. However, scarce data are available on the influence of previous ESD on LAG. The purpose of this study was to evaluate the feasibility and safety of LAG following incomplete ESD in patients with early gastric cancer. Ninety-seven patients who underwent LAG were analyzed retrospectively; 17 patients had undergone ESD previously and the remaining 80 patients had no history of ESD. Clinicopathological data and surgical outcomes were compared between the two groups. No differences were observed in surgical outcomes of LAG after ESD in terms of operation time, intraoperative blood loss, total number of harvested lymph nodes, time until start of flatus, and postoperative hospital stay. These results were not influenced by tumor location and operative procedures. In conclusion, in terms of surgical outcomes, LAG is a safe and feasible procedure for the treatment of early gastric cancer regardless of previous endoscopic treatment. LAG may be the first-choice radical treatment after incomplete ESD for early gastric cancer.

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1	Kim JJ, Lee JH, Jung HY, et al: EMR for early gastric cancer in Korea: a multicenter retrospective study. Gastrointest Endosc. 66:693–700. 2007. View Article : Google Scholar : PubMed/NCBI
2	Roukos DH: Current advances and changes in treatment strategy may improve survival and quality of life in patients with potentially curable gastric cancer. Ann Surg Oncol. 6:46–56. 1999. View Article : Google Scholar : PubMed/NCBI
3	Lee HJ, Yang HK and Ahn YO: Gastric cancer in Korea. Gastric Cancer. 5:177–182. 2002. View Article : Google Scholar
4	Tsujimoto H, Sugasawa H, Ono S, Ichikura T, Yamamoto J and Hase K: Has the accuracy of preoperative diagnosis improved in cases of early-stage gastric cancer? World J Surg. 34:1840–1846. 2010. View Article : Google Scholar : PubMed/NCBI
5	Itoh H, Oohata Y, Nakamura K, Nagata T, Mibu R and Nakayama F: Complete ten-year postgastrectomy follow-up of early gastric cancer. Am J Surg. 158:14–16. 1989.PubMed/NCBI
6	Lee HJ, Kim YH, Kim WH, et al: Clinicopathological analysis for recurrence of early gastric cancer. Jpn J Clin Oncol. 33:209–214. 2003. View Article : Google Scholar : PubMed/NCBI
7	Nakajima T: Gastric cancer treatment guidelines in Japan. Gastric Cancer. 5:1–5. 2002. View Article : Google Scholar
8	Kitano S, Iso Y, Moriyama M and Sugimachi K: Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 4:146–148. 1994.PubMed/NCBI
9	Kitano S, Shiraishi N, Uyama I, Sugihara K and Tanigawa N: A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 245:68–72. 2007. View Article : Google Scholar : PubMed/NCBI
10	Ziqiang W, Feng Q, Zhimin C, et al: Comparison of laparoscopically assisted and open radical distal gastrectomy with extended lymphadenectomy for gastric cancer management. Surg Endosc. 20:1738–1743. 2006. View Article : Google Scholar : PubMed/NCBI
11	Jiang X, Hiki N, Yoshiba H, et al: Laparoscopy-assisted gastrectomy in patients with previous endoscopic resection for early gastric cancer. Br J Surg. 98:385–390. 2011. View Article : Google Scholar : PubMed/NCBI
12	Japanese Classification of Gastric Carcinoma. 2nd English Edition. Gastric Cancer. 1. pp. 10–24. 1998, View Article : Google Scholar
13	Uyama I, Sugioka A, Matsui H, et al: Laparoscopic side-to-side esophagogastrostomy using a linear stapler after proximal gastrectomy. Gastric Cancer. 4:98–102. 2001. View Article : Google Scholar : PubMed/NCBI
14	Inaba K, Satoh S, Ishida Y, et al: Overlap method: novel intracorporeal esophagojejunostomy after laparoscopic total gastrectomy. J Am Coll Surg. 211:25–29. 2011. View Article : Google Scholar
15	Tanaka M, Ono H, Hasuike N and Takizawa K: Endoscopic submucosal dissection of early gastric cancer. Digestion. 77:23–28. 2008. View Article : Google Scholar
16	Nunobe S, Hiki N, Fukunaga T, et al: Previous laparotomy is not a contraindication to laparoscopy-assisted gastrectomy for early gastric cancer. World J Surg. 32:1466–1472. 2008. View Article : Google Scholar : PubMed/NCBI
17	Tokunaga M, Hiki N, Fukunaga T, et al: Quality control and educational value of laparoscopy-assisted gastrectomy in a high-volume center. Surg Endosc. 23:289–295. 2009.PubMed/NCBI
18	Tokunaga M, Hiki N, Fukunaga T, Nunobe S, Ohyama S and Yamaguchi T: Laparoscopy-assisted gastrectomy for patients with earlier upper abdominal open surgery. Surg Laparosc Endosc Percutan Tech. 20:16–19. 2010. View Article : Google Scholar : PubMed/NCBI
19	Tonouchi H, Mohri Y, Kobayashi M, Tanaka K, Ohi M and Kusunoki M: Laparoscopy-assisted distal gastrectomy with laparoscopic sentinel lymph node biopsy after endoscopic mucosal resection for early gastric cancer. Surg Endosc. 21:1289–1293. 2007. View Article : Google Scholar
20	Gotoda T, Yanagisawa A, Sasako M, et al: Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer. 3:219–225. 2000. View Article : Google Scholar : PubMed/NCBI
21	Oda I, Saito D, Tada M, et al: A multicenter retrospective study of endoscopic resection for early gastric cancer. Gastric Cancer. 9:262–270. 2006. View Article : Google Scholar : PubMed/NCBI