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Laparoscopic versus open distal gastrectomy for early gastric cancer in Japan: long-term clinical outcomes of a randomized clinical trial

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Abstract

Purpose

We report the long-term clinical outcomes of a randomized clinical trial comparing laparoscopy-assisted distal gastrectomy (LADG) with open DG (ODG).

Methods

Between 2005 and 2008, 63 patients with clinical T1 (cT1) gastric cancer were randomly assigned to undergo either LADG or ODG. Long-term clinical outcomes included prospective questionnaire-based symptoms and survival.

Results

Based on the responses to the prospective questionnaires, patients who underwent LADG reported greater satisfaction and were more likely to favor the procedure than those who underwent ODG. The most notable difference in symptoms was related to wound pain and diarrhea. After ODG, wound pain reduced in intensity but persisted throughout the follow-up. Surprisingly, diarrhea was more frequent after LADG than after ODG, possibly due to overeating, because symptoms elicited by overeating, such as vomiting after a meal or heartburn, were also more frequent after LADG. In terms of long-term survival, there were no cases of recurrence in either group.

Conclusions

LADG was associated with less wound pain during long-term follow-up after surgery, whereas symptoms related to overeating were common. Based on our findings and the patients’ reported satisfaction, we recommend LADG for cT1 gastric cancer as an effective procedure with excellent long-term survival.

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Authors and Affiliations

  1. Department of Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan

    Keishi Yamashita, Shiro Kikuchi, Nobue Futawatari, Natsuya Katada, Kei Hosoda, Hiromitsu Moriya, Hiroaki Mieno & Masahiko Watanabe

  2. Department of Upper Gastrointestinal Surgery, Saitama Medical University International Medical Center, Yamane 1397-1, Hidaka, Saitama, 350-1298, Japan

    Shinichi Sakuramoto

Authors
  1. Keishi Yamashita
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  2. Shinichi Sakuramoto
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  3. Shiro Kikuchi
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  4. Nobue Futawatari
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  5. Natsuya Katada
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  6. Kei Hosoda
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  7. Hiromitsu Moriya
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  8. Hiroaki Mieno
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  9. Masahiko Watanabe
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Corresponding author

Correspondence to Keishi Yamashita.

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Yamashita, K., Sakuramoto, S., Kikuchi, S. et al. Laparoscopic versus open distal gastrectomy for early gastric cancer in Japan: long-term clinical outcomes of a randomized clinical trial. Surg Today 46, 741–749 (2016). https://doi.org/10.1007/s00595-015-1221-4

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  • DOI: https://doi.org/10.1007/s00595-015-1221-4

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