Hand-Assisted Laparoscopic <i>Versus</i> Open Radical Resection for Remnant Gastric Cancer: A Comparison of Surgical Therapeutic Outcome_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LUOGuo-de , CAOYong-kuan , ZHANGLin , ZHANGGuo-hu , WANGPei-hong , GONGJia-qing

Gastrointestinal Ward of PLA General Surgery Centre, Chengdu Army General Hospital, Chengdu 610083, Sichuan Province, China;

Corresponding?author：

LUOGuo-de, Email: deguoluo@126.com

Keywords：

Hand-assisted laparoscope; Open surgery; Remnant gastric cancer; Radical gastrectomy

DOI：

10.7507/1007-9424.20160347

Video：

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Objective To explore feasibility and advantages of hand-assisted laparoscopic radical resection for remnant gastric cancer. Methods The clinical data of 26 patients with remnant gastric cancer who underwent hand-assisted laparoscopic (hand-assisted group, n=13) or open (open group, n=13) radical resection from December 2007 to May 2016 in this hospital were retrospectively analyzed. The perioperative outcomes were compared between these two groups. Results There was no conversion to open surgery in the hand-assisted group. Compared with the open group, the incision length was significantly reduced (P=0.000), the intraoperative blood loss was significantly decreased (P=0.038), postoperative the first anal exhaust time was significantly shortened (P=0.025) in the hand-assisted group. The operation time, the number of lymph nodes dissection, and the incidence of postoperative complications had no statistically significant differences between these two groups (P>0.05). Conclusion The preliminary results of limited cases in this study show that hand-assisted laparoscopic radical resection for remnant gastric cancer is safe and feasible, it has several advantages including small incisions, mild intraoperative hemorrhage, rapid postoperative recovery, better recent clinical therapeutic outcome and so on as compared with open surgery.

Citation： LUOGuo-de, CAOYong-kuan, ZHANGLin, ZHANGGuo-hu, WANGPei-hong, GONGJia-qing. Hand-Assisted Laparoscopic Versus Open Radical Resection for Remnant Gastric Cancer: A Comparison of Surgical Therapeutic Outcome. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(11): 1358-1361. doi: 10.7507/1007-9424.20160347 Copy

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2.	秦新裕, 劉鳳林. 重視殘胃癌的診斷和治療. 中國實用外科雜志, 2009, 29(10):798-799.
3.	戴冬秋. 早期殘胃癌的臨床病理特點與合理治療. 中國實用外科雜志, 2009, 29(10):800-802.
4.	Shinohara T, Hanyu N, Tanaka Y, et al. Totally laparoscopic comp-lete resection of the remnant stomach for gastric cancer. Langenbecks Arch Surg, 2013, 398(2):341-345.
5.	武愛文, 季加孚. 殘胃癌診斷與微創治療應用現狀. 中華胃腸外科雜志, 2013, 16(2):132-134.
6.	曹永寬, 周均, 劉立業, 等. 手輔助腹腔鏡與腹腔鏡輔助胃癌D2根治術的臨床對照研究. 中國普外基礎與臨床雜志, 2012, 19(11):1208-1212.
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9.	Mezhir JJ, Gonen M, Ammori JB, et al. Treatment and outcome of patients with gastric remnant cancer after resection for peptic ulcer disease. Ann Surg Oncol, 2011, 18(3):670-676.
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11.	Sasaki K, Fujiwara Y, Kishi K, et al. Pathological findings of gastric mucosa in patients with gastric remnant cancer. Hepatogastroentero-logy, 2014, 61(129):251-254.
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13.	Hosokawa Y, Konishi M, Sahara Y, et al. Limited subtotal gastrec-tomy for early remnant gastric cancer. Gastric Cancer, 2014, 17(2):332-336.
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16.	Nozaki I, Hato S, Kurita A. A new technique for resecting gastric remnant cancer after proximal gastrectomy with jejunal interposition. Surg Today, 2012, 42(11):1135-1138.
17.	Komatsu S, Ichikawa D, Okamoto K, et al. Differences of the lymp-hatic distribution and surgical outcomes between remnant gastric cancers and primary proximal gastric cancers. J Gastrointest Surg, 2012, 16(3):503-508.
18.	Meyer F, Benedix F, Garlipp B, et al. Gastric stump carcinoma-a surgical and oncological challenge. Z Gastroenterol, 2011, 49(9):1270-1275.
19.	鄧洪強, 吳鴻根, 劉超. 殘胃癌淋巴結轉移的相關研究. 中國普外基礎與臨床雜志, 2013, 20(5):536-539.
20.	趙冬雨, 成麗婭, 于健. 60例殘胃癌的臨床特點及外科治療體會. 中國普外基礎與臨床雜志, 2014, 21(3):352-354.
21.	王曄, 丁士剛. 殘胃癌發病機制及治療. 癌癥進展, 2016, 14(1):4-6.
22.	Nagai E, Nakata K, Ohuchida K, et al. Laparoscopic total gastrectomy for remnant gastric cancer:feasibility study. Surg Endosc, 2014, 28(1):289-296.
23.	曹永寬, 劉立業, 羅國德, 等. 手輔助腹腔鏡行胃癌D2根治術的手術安全與技術路徑探討. 中國普通外科雜志, 2012, 21(4):373-376.
24.	Gong J, Cao Y, Wang Y, et al. Three-step hand-assisted laparoscopic D2 radical gastrectomy for Chinese obese patients:a highly efficient and feasible surgical approach. J Cancer, 2015, 6(2):120-127.
25.	Gong J, Cao Y, Li Y, et al. Hand-assisted laparoscopic versus laparo-scopy-assisted D2 radical gastrectomy:a prospective study. Surg Endosc, 2014, 28(10):2998-3006.

1. 鐘曉剛, 殷舞, 麥威, 等. 殘胃癌外科治療臨床分析及再認識. 中國普外基礎與臨床雜志, 2012, 19(1):20-24.
2. 秦新裕, 劉鳳林. 重視殘胃癌的診斷和治療. 中國實用外科雜志, 2009, 29(10):798-799.
3. 戴冬秋. 早期殘胃癌的臨床病理特點與合理治療. 中國實用外科雜志, 2009, 29(10):800-802.
4. Shinohara T, Hanyu N, Tanaka Y, et al. Totally laparoscopic comp-lete resection of the remnant stomach for gastric cancer. Langenbecks Arch Surg, 2013, 398(2):341-345.
5. 武愛文, 季加孚. 殘胃癌診斷與微創治療應用現狀. 中華胃腸外科雜志, 2013, 16(2):132-134.
6. 曹永寬, 周均, 劉立業, 等. 手輔助腹腔鏡與腹腔鏡輔助胃癌D2根治術的臨床對照研究. 中國普外基礎與臨床雜志, 2012, 19(11):1208-1212.
7. 張斌. 殘胃癌的臨床診治分析. 中國實用醫藥, 2012, 3(7):82-83.
8. Komatsu S, Ichikawa D, Okamoto K, et al. Progression of remnant gastric cancer is associated with duration of follow-up following distal gastrectomy. World J Gastroenterol, 2012, 18(22):2832-2836.
9. Mezhir JJ, Gonen M, Ammori JB, et al. Treatment and outcome of patients with gastric remnant cancer after resection for peptic ulcer disease. Ann Surg Oncol, 2011, 18(3):670-676.
10. 陳金元. 不同術式治療殘胃癌患者的預后及相關影響因素分析. 局解手術學雜志, 2014, 23(2):189-190.
11. Sasaki K, Fujiwara Y, Kishi K, et al. Pathological findings of gastric mucosa in patients with gastric remnant cancer. Hepatogastroentero-logy, 2014, 61(129):251-254.
12. Okaniwa A, Murayama I, Watanabe Y, et al. A patient with advanced remnant gastric cancer responding completely to S-1 monotherapy. Gan To Kagaku Ryoho, 2011, 38(7):1191-1195.
13. Hosokawa Y, Konishi M, Sahara Y, et al. Limited subtotal gastrec-tomy for early remnant gastric cancer. Gastric Cancer, 2014, 17(2):332-336.
14. Di Leo A, Pedrazzani C, Bencivenga M, et al. Gastric stump cancer after distal gastrectomy for benign disease:clinicopathological features and surgical outcomes. Ann Surg Oncol, 2014, 21(8):2594-2600.
15. Tokunaga M, Sano T, Ohyama S, et al Clinicopathological charac-teristics and survival difference between gastric stump carcinoma and primary upper third gastric cancer. J Gastrointest Surg, 2013, 17 (2):313-318.
16. Nozaki I, Hato S, Kurita A. A new technique for resecting gastric remnant cancer after proximal gastrectomy with jejunal interposition. Surg Today, 2012, 42(11):1135-1138.
17. Komatsu S, Ichikawa D, Okamoto K, et al. Differences of the lymp-hatic distribution and surgical outcomes between remnant gastric cancers and primary proximal gastric cancers. J Gastrointest Surg, 2012, 16(3):503-508.
18. Meyer F, Benedix F, Garlipp B, et al. Gastric stump carcinoma-a surgical and oncological challenge. Z Gastroenterol, 2011, 49(9):1270-1275.
19. 鄧洪強, 吳鴻根, 劉超. 殘胃癌淋巴結轉移的相關研究. 中國普外基礎與臨床雜志, 2013, 20(5):536-539.
20. 趙冬雨, 成麗婭, 于健. 60例殘胃癌的臨床特點及外科治療體會. 中國普外基礎與臨床雜志, 2014, 21(3):352-354.
21. 王曄, 丁士剛. 殘胃癌發病機制及治療. 癌癥進展, 2016, 14(1):4-6.
22. Nagai E, Nakata K, Ohuchida K, et al. Laparoscopic total gastrectomy for remnant gastric cancer:feasibility study. Surg Endosc, 2014, 28(1):289-296.
23. 曹永寬, 劉立業, 羅國德, 等. 手輔助腹腔鏡行胃癌D2根治術的手術安全與技術路徑探討. 中國普通外科雜志, 2012, 21(4):373-376.
24. Gong J, Cao Y, Wang Y, et al. Three-step hand-assisted laparoscopic D2 radical gastrectomy for Chinese obese patients:a highly efficient and feasible surgical approach. J Cancer, 2015, 6(2):120-127.
25. Gong J, Cao Y, Li Y, et al. Hand-assisted laparoscopic versus laparo-scopy-assisted D2 radical gastrectomy:a prospective study. Surg Endosc, 2014, 28(10):2998-3006.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Hand-Assisted Laparoscopic Versus Open Radical Resection for Remnant Gastric Cancer: A Comparison of Surgical Therapeutic Outcome

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