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Annals of Surgical Oncology

, Volume 21, Issue 6, pp 2028–2035 | Cite as

Feasibility and Nutritional Impact of Laparoscopy-assisted Subtotal Gastrectomy for Early Gastric Cancer in the Upper Stomach

  • Toshiyuki Kosuga
  • Naoki Hiki
  • Souya Nunobe
  • Hisashi Noma
  • Michitaka Honda
  • Shinya Tanimura
  • Takeshi Sano
  • Toshiharu Yamaguchi
Gastrointestinal Oncology

Abstract

Background

Laparoscopy-assisted total gastrectomy (LATG) is commonly performed for early gastric cancer (EGC) in the upper stomach; however, the incidence of anastomotic complications remains high, and postoperative nutritional status is not satisfactory. This study aimed to evaluate the feasibility and nutritional impact of a novel surgical procedure, laparoscopy-assisted subtotal gastrectomy (LAsTG).

Methods

This was a retrospective study of 167 patients with EGC in the upper stomach. Of these, 57 patients underwent LAsTG, while 110 patients underwent LATG. Postoperative change in body weight, and serum concentration of albumin (Alb) and total protein (TP) were compared between the LAsTG and LATG groups. Analysis of covariance (ANCOVA) was used to assess the influence of potential confounding factors.

Results

Frequency of anastomotic complications was significantly higher in the LATG group (16.3 %) than in the LAsTG group (5.3 %, P = 0.040). Postoperative recovery of body weight at 12 months after surgery was significantly better in the LAsTG group (89.8 ± 1.4 %) than in the LATG group (82.1 ± 1.0 %, P < 0.001). By ANCOVA, adjusted mean differences of Alb and TP at 12 months after surgery between the LAsTG and LATG groups were 0.226 g/dl (95 % CI 0.141–0.312; P < 0.001) and 0.380 g/dl (95 % CI 0.265–0.495; P < 0.001); thus, the surgical procedure was significantly associated with the postoperative Alb and TP levels.

Conclusions

LAsTG could be a better choice than LATG for EGC in the upper stomach as a result of improvements in the incidence of anastomotic complications and postoperative nutritional status.

Keywords

Endoscopic Submucosal Dissection Early Gastric Cancer Proximal Gastrectomy Anastomotic Complication Open Distal Gastrectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Disclosure

The authors declare no conflict of interest.

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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Toshiyuki Kosuga
    • 1
  • Naoki Hiki
    • 1
  • Souya Nunobe
    • 1
  • Hisashi Noma
    • 2
  • Michitaka Honda
    • 1
  • Shinya Tanimura
    • 1
  • Takeshi Sano
    • 1
  • Toshiharu Yamaguchi
    • 1
  1. 1.Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
  2. 2.Department of Data ScienceThe Institute of Statistical MathematicsTokyoJapan

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