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Influence of endoscopic resection on additional laparoscopic distal gastrectomy: a propensity score-matching analysis

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Abstract

Purpose

There is no definite evidence of the feasibility and safety of laparoscopic distal gastrectomy (LDG) for patients who have undergone incomplete endoscopic resection (ER). We investigated the influence of ER prior to LDG by a propensity score matching analysis.

Methods

We retrospectively analyzed the outcomes of gastric cancer patients who underwent LDG with or without prior ER from 2000 to 2014. Propensity score matching was performed to compare the two groups of patients.

Results

After matching, 47 patients in the ER group and 94 patients in the non-ER group were selected from a total of 365 patients. A residual tumor was observed in 10 of 47 patients (21.3%). The mean number of dissected lymph nodes in the non-ER group (39.4 ± 14.5) was higher than that in the ER group (31.7 ± 13.5) (P = 0.003). However, other perioperative data, such as the operation time and blood loss volume were similar. The complication rate of the ER group (17.0%) and the non-ER group (9.6%) did not differ to a statistically significant extent (P = 0.2). Among these patients, 6 died during the 5-year follow-up period, but no patients showed signs of recurrence.

Conclusion

ER prior to surgical resection showed no significant influence on postoperative complications or mortality. LDG can be safely performed to achieve radical resection after incomplete ER.

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Abbreviations

ER:

Endoscopic resection

ESD:

Endoscopic submucosal dissection

EMR:

Endoscopic mucosal resection

LDG:

Laparoscopic distal gastrectomy

LADG:

Laparoscopy-assisted distal gastrectomy

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Acknowledgements

We thank Edanz group (www.edanzediting.com/ac) for editing a draft of this manuscript.

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Author notes

  1. Koji Shindo and Jaymel Castillo Co-first authors.

Authors and Affiliations

  1. Departments of Surgery and Oncology, Kyushu University Hospital, 3-1-1 Maidashi, Higashiku, Fukuokashi, Fukuoka, Japan

    Koji Shindo, Jaymel Castillo, Kenoki Ohuchida, Taiki Moriyama, Shuntaro Nagai, Takao Ohtsuka, Eishi Nagai, Shuji Shimizu & Masufumi Nakamura

  2. International Medical Department, Fukuokashi, Fukuoka, Japan

    Jaymel Castillo, Tomohiko Moriyama & Shuji Shimizu

  3. Department of Endoscopic Diagnostics and Therapeutics, Fukuokashi, Fukuoka, Japan

    Taiki Moriyama & Takao Ohtsuka

  4. Department of Medicine and Clinical Science, Kyushu University Hospital, 3-1-1 Maidashi, Higashiku, Fukuokashi, Fukuoka, Japan

    Tomohiko Moriyama

  5. Department of Surgery, Fukuoka Red Cross Hospital, Fukuokashi, Fukuoka, Japan

    Eishi Nagai

Authors
  1. Koji Shindo
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  2. Jaymel Castillo
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Corresponding author

Correspondence to Kenoki Ohuchida.

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The authors declare no conflicts of interest in association with the present study.

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Shindo, K., Castillo, J., Ohuchida, K. et al. Influence of endoscopic resection on additional laparoscopic distal gastrectomy: a propensity score-matching analysis. Surg Today 50, 1290–1296 (2020). https://doi.org/10.1007/s00595-020-02012-8

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  • DOI: https://doi.org/10.1007/s00595-020-02012-8

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