Safety and Efficacy of Laparoscopy-Assisted Gastrectomy after Endoscopic Submucosal Dissection for Early Gastric Cancer: A Retrospective Report

Takahisa Suzuki, Kazuaki Tanabe, Dang Thuc Anh Vu, Toshihiro Misumi, Nobuaki Fujikuni, Noriaki Tokumoto, Hideki Ohdan

Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiro-shima University, Hiroshima, Japan..

DOI: 10.4236/jct.2013.41A008                

Abstract

Background: This study aimed to determine the safety and effectiveness of laparoscopy-assisted distal gastrectomy (LADG) after ESD. Methods: We reviewed patients with gastric cancer who underwent distal gastrectomy after non-curative ESD from May 2000 to July 2010, and classified them into LADG-ESD and open distal gastrectomy (ODG) after non-curative ESD (ODG-ESD). In addition, we analyzed the standard LADG (LADG-standard) during the same period. We retrospectively analyzed surgical outcomes and survival in these 3 groups. Pathological results after gastrectomy were compared between the LADG-ESD and ODG-ESD; Results: Sixty-one patients underwent distal gastrectomy after non-curative ESD. No differences in overall survival were found between the LADG-ESD and ODG-ESD. The average duration to surgery after ESD was 42.4 days. Although the average surgical duration and average length of hospital stay after surgery were longer in the LADG-ESD than in the ODG-ESD, number of LN dissections was statistically identical in these 2 groups. Operative complications in the LADG-ESD (16.0%) was higher than that in the LADG-standard (3.8% - 8.2%) but similar to that in the ODG-ESD (13.9%). Conclusion: The present study suggests that LADG contributes to the effectiveness of the treatment of choice for non-curative endoscopic resection.

Keywords

Early Gastric Cancer; Laparoscopic Gastrectomy; ESD

Conflicts of Interest

The authors declare no conflicts of interest.

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