-
J. Gastrointest. Surg. · Sep 2014
Multicenter Study Comparative StudyA multi-institutional analysis of open versus minimally-invasive surgery for gastric adenocarcinoma: results of the US gastric cancer collaborative.
- Gaya Spolverato, Yuhree Kim, Aslam Ejaz, Vicente Valero, Malcolm H Squires, George Poultsides, Ryan C Fields, Mark Bloomston, Sharon M Weber, Alexandra W Acher, Konstantinos Votanopoulos, Carl Schmidt, Clifford S Cho, Shishir K Maithel, and Timothy M Pawlik.
- Department of Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 688, Baltimore, MD, 21287, USA.
- J. Gastrointest. Surg. 2014 Sep 1; 18 (9): 1563-74.
BackgroundSurgical experience with minimally invasive surgery (MIS) has increased; however, published reports on MIS resection of gastric adenocarcinoma are limited.MethodsBetween 2000 and 2012, 880 patients who underwent surgical resection of gastric adenocarcinoma were identified from a multi-institutional database. Clinicopathological characteristics, operative details, and outcomes were stratified by operative approach (open vs. MIS) and analyzed.ResultsOverall, 70 (8 %) patients had a MIS approach. Patients who underwent a MIS resection were more likely to have a smaller tumor (open 4.5 cm vs. MIS 3.0 cm, p < 0.001). MIS resections were associated with lower estimated blood loss (open 250 cc vs. MIS 150 cc) and longer operative time (open 232 min vs. MIS 271 min) compared with open surgery (both p < 0.05). An R0 resection was achieved in most patients (open 90.9 % vs. MIS 98.6 %, p = 0.03) and median lymph node yield was good in both groups (open 17 vs. MIS 14, p = 0.10). MIS had a similar incidence of complications (open 33.1 % vs. MIS 20 %, p = 0.07) and a similar length of stay (open 9 days vs. MIS 7 days, p = 0.13) compared with open surgery. In the propensity-matched analysis, median recurrence-free and overall were not impacted by operative approach.ConclusionAn MIS approach to gastric cancer was associated with adequate lymph node retrieval, a high incidence of R0 resection, and comparable long-term oncological outcomes versus open gastrectomy.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.