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Safety of laparoscopic radical gastrectomy in gastric cancer patients with liver cirrhosis

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Abstract

Background

Laparoscopic gastrectomy (LG) in gastric cancer patients with liver cirrhosis (LC) has rarely been reported. In this study, we aimed to elucidate the feasibility of LG compared with that of open gastrectomy (OG) for LC patients.

Methods

Of the 75 LC patients who underwent radical gastrectomy for gastric cancer between April 2005 and March 2014, 36 patients who underwent LG were compared with 39 patients who underwent OG. Comparisons were based on clinicopathologic characteristics, surgical outcomes, and long-term survival rates.

Results

Comparison of LG and OG revealed no significant differences in the clinicopathologic characteristics. Five patients in the LG group and eight in the OG group showed a Child–Turcotte–Pugh score (CTPs) over A. In surgical outcomes, we observed shorter operation times (191.4 ± 63.9 vs. 225.9 ± 77.1 min, p = 0.039), reduced estimated blood loss (175.5 ± 214.1 vs. 396.9 ± 514.8 ml, p = 0.021), and shorter hospital stays (10.4 ± 4.6 vs. 13.7 ± 5.8 days, p = 0.008) in LG than OG. Regarding postoperative morbidity, 7 (19.4%) and 10 (25.6%) complications were observed in the LG and OG groups, respectively. There was no difference in complications between the two groups regardless of the CTPs. One patient with a CTPs of C succumbed to hepatic failure following LG. Long-term survival and overall and recurrence-free survival rates did not differ between the two groups.

Conclusions

Even in cases with CTPs B, LG with lymph node dissection for gastric cancer patient was safer and acceptable than OG was. Therefore, LG can be considered an alternative surgical approach in gastric cancer with LC.

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Authors and Affiliations

  1. Department of Surgery, College of Medicine, The Catholic University of Korea, #327 Sosaro, Won-mi Gu, Bucheon, Gyeonggido, Republic of Korea

    Dong Jin Kim, Cho Hyun Park, Wook Kim, Hyung Min Jin, Jin Jo Kim, Han Hong Lee & Jun Hyun Lee

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  1. Dong Jin Kim
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  2. Cho Hyun Park
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  3. Wook Kim
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  4. Hyung Min Jin
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Correspondence to Jun Hyun Lee.

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Disclosures

Dong Jin Kim, Cho Hyun Park, Wook Kim, Hyung Min Jin, Jin Jo Kim, Han Hong Lee, and Jun Hyun Lee have nothing to disclose.

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Kim, D.J., Park, C.H., Kim, W. et al. Safety of laparoscopic radical gastrectomy in gastric cancer patients with liver cirrhosis. Surg Endosc 31, 3898–3904 (2017). https://doi.org/10.1007/s00464-017-5420-5

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  • DOI: https://doi.org/10.1007/s00464-017-5420-5

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