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Annals of Surgical Oncology

, Volume 22, Supplement 3, pp 929–935 | Cite as

Feasibility and Nutritional Benefits of Laparoscopic Proximal Gastrectomy for Early Gastric Cancer in the Upper Stomach

  • Toshiyuki Kosuga
  • Daisuke IchikawaEmail author
  • Shuhei Komatsu
  • Kazuma Okamoto
  • Hirotaka Konishi
  • Atsushi Shiozaki
  • Hitoshi Fujiwara
  • Eigo Otsuji
Gastrointestinal Oncology

Abstract

Background

Laparoscopic proximal gastrectomy (LPG) has recently been applied for early gastric cancer (EGC) in the upper stomach as a minimally invasive and function-preserving surgery. This study aimed to clarify the feasibility and nutritional benefits of LPG over laparoscopic total gastrectomy (LTG).

Methods

This was a retrospective study of 77 patients with clinical stage I gastric cancer in the upper stomach. Of these patients, 25 underwent LPG, while 52 underwent LTG. Surgical outcomes and postoperative nutritional status such as changes in body weight and blood chemistries were compared between LPG and LTG.

Results

Intraoperative blood loss and C-reactive protein levels at 3 and 7 days after surgery were significantly lower in LPG than in LTG (p = 0.018, 0.036, and 0.042, respectively). No significant differences were observed in postoperative early or late complication rates between LPG and LTG. The incidence of Los Angeles Grade B or more severe reflux esophagitis after LPG was 9.1 %, which was similar to that after LTG (9.3 %). Postoperative changes in body weight at 6 months and 1 and 2 years after surgery were consistently less in LPG than in LTG (p = 0.001, 0.022, and 0.001, respectively). Moreover, postoperative levels of hemoglobin and serum albumin and total lymphocyte count were also higher in LPG than in LTG.

Conclusion

LPG may be a better choice for EGC in the upper stomach than LTG because it has distinct advantages in terms of surgical invasiveness and postoperative nutritional status.

Keywords

Early Gastric Cancer Reflux Esophagitis Anastomotic Stricture Remnant Stomach Laparoscopic 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

Toshiyuki Kosuga, Daisuke Ichikawa, Shuhei Komatsu, Kazuma Okamoto, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, and Eigo Otsuji declare that they have no conflicts of interest.

Supplementary material

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Supplementary material 1 (DOCX 101 kb)
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Supplementary material 2 (DOCX 109 kb)
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Supplementary material 3 (DOCX 1249 kb)

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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Toshiyuki Kosuga
    • 1
  • Daisuke Ichikawa
    • 1
    Email author
  • Shuhei Komatsu
    • 1
  • Kazuma Okamoto
    • 1
  • Hirotaka Konishi
    • 1
  • Atsushi Shiozaki
    • 1
  • Hitoshi Fujiwara
    • 1
  • Eigo Otsuji
    • 1
  1. 1.Division of Digestive Surgery, Department of SurgeryKyoto Prefectural University of MedicineKyotoJapan

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