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Laparoscopic Proximal Gastrectomy Maintains Body Weight and Skeletal Muscle Better Than Total Gastrectomy

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Abstract

Background

Laparoscopic proximal gastrectomy (LPG) is performed as a function-preserving surgery for patients with early proximal gastric malignant tumors; however, whether LPG has advantages postoperatively compared with laparoscopic total gastrectomy (LTG) is debatable, especially with regard to nutritional outcomes.

Methods

We evaluated 20 patients who underwent LTG and 10 patients who underwent LPG with double tract reconstruction (LPG-DT) who were diagnosed preoperatively with T1a or T1b N0 Stage IA gastric cancer in our department in the same time period. The statistical relevance of complications, surgical maneuvers, clinical factors and changes in weight, skeletal muscle index (SMI) and serum albumin levels after surgery was compared between the LPG-DT group and the LTG group.

Results

No differences between groups were observed in patient demographics, operation time, blood loss, complications, number of dissected lymph nodes and pathological stage. The body weight reduction rate was significantly lower in the LPG-DT group compared with the LTG group at 6 months (5.7 vs. 14.9%, respectively; p = 0.0045) and 1 year after surgery (9.6 vs. 17.9%, respectively; p = 0.0042). The SMI reduction rate of the LPG-DT group in the first postoperative year was significantly lower than that of the LTG group (9.3 vs. 18.3%, respectively; p = 0.0057).

Conclusions

Patients with early gastric cancer who underwent LPG-DT had acceptable morbidity and mortality, similar to those who underwent LTG. Body weight and SMI reduction rates were lower in the LPG-DT group than in the LTG group. Thus, LPG-DT is an appropriate procedure for patients with clinical Stage IA proximal gastric cancer.

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Acknowledgments

This work was supported by JSPS KAKENHI Grant Number JP17K16564.

Author information

Authors and Affiliations

  1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Masahiko Sugiyama, Eiji Oki, Koji Ando, Yuichiro Nakashima, Hiroshi Saeki & Yoshihiko Maehara

  2. Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan

    Masahiko Sugiyama

Authors
  1. Masahiko Sugiyama
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  2. Eiji Oki
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  3. Koji Ando
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  4. Yuichiro Nakashima
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  5. Hiroshi Saeki
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  6. Yoshihiko Maehara
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Contributions

MS designed the study and wrote the manuscript. EO and HS provided advice and edited the manuscript. KA and YN gathered data from each institute. YM discussed the results and commented on the manuscript.

Corresponding author

Correspondence to Masahiko Sugiyama.

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The authors declare that they have no competing financial interests.

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Sugiyama, M., Oki, E., Ando, K. et al. Laparoscopic Proximal Gastrectomy Maintains Body Weight and Skeletal Muscle Better Than Total Gastrectomy. World J Surg 42, 3270–3276 (2018). https://doi.org/10.1007/s00268-018-4625-7

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  • DOI: https://doi.org/10.1007/s00268-018-4625-7

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